目的:比较髋关节和膝关节置换术患者对护士主导的循证静脉血栓栓塞预防计划(干预)的依从性和相关的临床结果。
背景:住院患者的静脉血栓栓塞发病率和死亡率是卫生专业人员的主要关注点。已经制定了静脉血栓栓塞预防指南;然而,遵守准则是可变的。
方法:有410名潜在参与者,他们是成年患者,在2年的研究期间(2011-2013年)在两个研究中心进行择期髋或膝关节置换术。其中,27人不符合纳入标准,其余符合纳入研究条件(干预点n=196,对照组n=187,总人口n=383).
方法:本研究采用准实验设计,使用干预和对照研究网站,在澳大利亚一个地区的两家私立医院进行。
结果:干预组的平均依从性评分为11.09,高于对照组的7.19。这相当于85%和55%的合规率,分别,并表明在研究地点的依从性明显更高。出院后患者的依从性和结局在研究地点之间没有显着差异。
结论:这项研究表明,护士主导的干预措施在将循证指南转化为髋关节和膝关节置换术患者的常规患者护理方面取得了很高的依从性。护士对于实施临床实践指南和在急性护理中采用预防计划以改善患者预后并减少关节置换术患者的术后静脉血栓栓塞至关重要。
结论:这项研究证明了护士领导将预防静脉血栓栓塞的循证实践指南转化为常规患者护理的能力。
OBJECTIVE: To measure adherence to a nurse-led evidence-based venous thromboembolism prevention programme (intervention) compared to usual care in hip and knee arthroplasty patients and associated clinical outcomes.
BACKGROUND: Venous thromboembolism morbidity and mortality of hospitalised patients is a major concern for health professionals. Venous thromboembolism prevention
guidelines have been developed; however, adherence to
guidelines is variable.
METHODS: There were 410 potential participants who were adult patients that were booked for elective hip or knee arthroplasty at the two study sites during a 2-year period (2011-2013). Of these, 27 did not meet the inclusion criteria, and the remainder were eligible for inclusion in the study (intervention site n = 196 and control site n = 187, total population n = 383).
METHODS: This study adopted a quasi-experimental design, using an intervention and control study site, conducted in two private hospitals in a regional area in Australia.
RESULTS: The intervention group had a mean compliance score of 11.09, higher than the control group score of 7.19. This is equivalent to a compliance rate of 85% and 55%, respectively, and indicates that adherence at the study site was significantly higher. Patient adherence and outcomes in the postdischarge period were not significantly different between the study sites.
CONCLUSIONS: This study demonstrated a nurse-led intervention achieved high adherence with translating evidence-based
guidelines into routine patient care for hip and knee arthroplasty patients. Nurses can be critical to implementing clinical practice
guidelines and adopting preventive programmes in acute care to improve patient outcomes and reduce postoperative venous thromboembolism in arthroplasty patients.
CONCLUSIONS: This research demonstrates the capacity of nurses to lead the translation of evidence-based practice
guidelines for prevention of venous thromboembolism into routine patient care.