evidence‐based nursing

  • 文章类型: Journal Article
    本综述的目的是确定中风患者当前的支持性护理需求,根据支持性护理需求框架(SCNF)对这些需求进行分类,并形成卒中患者的SCNF。遵循系统审查的首选报告项目和范围审查的元扩展(PRISMA-ScR)和进行系统范围审查的指南。搜索了十个数据库,包括六个英文数据库:PubMed,Embase,WebofScience,护理相关健康文献的累积指数,科克伦图书馆,和PsycINFO,和四个中国数据库:中国国家知识基础设施,万芳,中国生物医药数据库和重庆VIP.检索期从数据库建立到2022年12月31日。筛选了三千二十九次点击,最终文献综述中纳入了34篇文章。中风患者最大的需求是信息,其次是心理,社会,康复,实用,物理,情感,和精神需求。确定了中风患者的支持性护理需求。根据惠誉的SCNF,开发了中风患者的初步SCNF。需要解决中风患者的多种现有需求。这篇综述可能是首次开发针对卒中患者的SCNF。这项工作可能为未来研究中风患者的支持性护理需求奠定基础,并为在临床中风单位实施支持性护理提供框架。
    The aims of the current review were to identify the current supportive care needs of stroke patients, categorize those needs according to the supportive care needs framework (SCNF), and to form a SCNF of stroke patients. Preferred Reporting Items for Systematic Reviews and Meta-Extension for Scoping Reviews (PRISMA-ScR) and Guidance for conducting systematic scoping reviews were followed. Ten databases were searched, including six English databases: PubMed, Embase, Web of Science, Cumulative Index to Nursing Allied Health Literature, Cochrane Library, and PsycINFO, and four Chinese databases: China National Knowledge Infrastructure, Wan Fang, China Biology Medicine Database and Chongqing VIP. The search period covers from the establishment of the database to December 31, 2022. Three thousand twenty-nine hits were screened resulting in the inclusion of 34 articles in the final literature review. The greatest need identified by stroke patients was information, followed by psychological, social, rehabilitation, practical, physical, emotional, and spiritual needs. The supportive care needs of stroke patients were identified. A preliminary SCNF of stroke patients was developed according to Fitch\'s SCNF. The multitude of existing needs of stroke patients need to be addressed. This review may represent the first time that SCNF for stroke patients has been developed. This work may lay the foundation for future research on the supportive care needs of stroke patients and provide a framework for the implementation of supportive care in clinical stroke units.
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  • 文章类型: Journal Article
    背景:临床医生寻求信息的行为会影响患者护理质量。早期的研究表明,获取信息的障碍阻止临床医生寻求临床问题的答案。
    目的:探索初级保健临床医生在护理点寻求信息的行为,专注于他们何时以及如何寻求临床问题的答案。
    方法:对45名临床医生进行了半结构化访谈,以调查他们寻求信息的习惯。一周后,对那些打算解决未回答的问题的人进行了后续采访。
    结果:三分之二的临床医生在护理期间遇到问题,近四分之三的人在会议期间解决了这些问题。同事们,指南和在线平台是常见的信息来源,智能手机被用来访问谷歌,WhatsApp或UpToDate®。促进者包括可靠的来源和确认知识的动力,而障碍包括无效的搜索方法和高工作量。尽管面临挑战,大多数临床医生对他们的信息寻求过程表示满意.
    结论:研究结果强调新加坡初级保健临床医生越来越多地使用智能手机获取临床信息,并建议需要量身定制的培训计划和指南来优化信息寻求实践。
    结论:这项研究的见解可以为旨在改善初级保健临床医生的信息寻求实践的培训计划和指南的制定提供信息。有可能提高患者护理质量。
    BACKGROUND: Clinicians\' information-seeking behaviours impact patient care quality. Earlier studies indicated that barriers to accessing information deter clinicians from seeking answers to clinical questions.
    OBJECTIVE: To explore primary care clinicians\' information-seeking behaviour at point-of-care, focusing on when and how they seek answers to clinical questions.
    METHODS: Semi-structured interviews were conducted with 45 clinicians after clinical sessions to investigate their information-seeking habits. Follow-up interviews were conducted after a week for those intending to address unanswered queries.
    RESULTS: Two thirds of clinicians encountered questions during care, with nearly three quarters resolving them during the session. Colleagues, guidelines and online platforms were common information sources, with smartphones being used to access Google, WhatsApp or UpToDate®. Facilitators included reliable sources and the drive to confirm knowledge, while barriers included ineffective search methods and high workload. Despite challenges, most clinicians expressed satisfaction with their information-seeking process.
    CONCLUSIONS: The findings underscore the increasing use of smartphones for accessing clinical information among Singaporean primary care clinicians and suggest the need for tailored training programmes and guidelines to optimise information-seeking practices.
    CONCLUSIONS: Insights from this study can inform the development of training programmes and guidelines aimed at improving information-seeking practices among primary care clinicians, potentially enhancing patient care quality.
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  • 文章类型: Journal Article
    采用Meta分析综合评价循证护理(EBN)干预对重症监护病房(ICU)患者压力性损伤(PI)的影响。进行了计算机搜索,从数据库成立到2023年11月,在万方,PubMed,中国国家知识基础设施,谷歌学者,Embase,和Cochrane图书馆在ICU患者中应用EBN干预措施的随机对照试验(RCTs)。两名独立研究人员对文献进行了筛选,提取的数据,进行质量评价。采用Stata17.0软件进行数据分析。总的来说,25个随机对照试验,涉及2494名ICU患者,包括在内。研究发现,与常规护理方法相比,在ICU患者中实施EBN干预措施显着降低了PI的发生(比值比[OR]:0.22,95%置信区间[CI]:0.17-0.30,p<0.001),延迟了压疮的发病时间(标准化平均差[SMD]:-1.61,95%CI:-2.00至-1.22,p<0.001),也改善了护理满意度(OR:1.18,95%CI:1.14-1.23,p<0.001)。我们的研究结果表明,在ICU患者的PI护理中实施EBN干预措施非常有价值,可以减少PI的发生,可以延迟出现的时间,并且与相对较高的护理满意度相关,使其值得推广。
    A meta-analysis was conducted comprehensively to investigate the impact of evidence-based nursing (EBN) interventions on pressure injury (PI) in the intensive care unit (ICU) patients. Computer searches were performed, from databases inception to November 2023, in Wanfang, PubMed, China National Knowledge Infrastructure, Google Scholar, Embase, and Cochrane Library for randomized controlled trials (RCTs) on the application of EBN interventions in ICU patients. Two independent researchers conducted screenings of the literature, extracted data, and carried out quality evaluations. Stata 17.0 software was employed for data analysis. Overall, 25 RCTs, involving 2494 ICU patients, were included. It was found that compared to conventional care methods, the implementation of EBN interventions in ICU patients markedly decreased the occurrence of PI (odds ratio [OR]: 0.22, 95% confidence interval [CI]: 0.17-0.30, p < 0.001), delayed the onset time of pressure ulcers (standardized mean difference [SMD]: -1.61, 95% CI: -2.00 to -1.22, p < 0.001), and also improved nursing satisfaction (OR: 1.18, 95% CI: 1.14-1.23, p < 0.001). Our findings suggest the implementation of EBN interventions in the care of PI in ICU patients is highly valuable, can reduce the occurrence of PI, can delay the time of appearance, and is associated with relatively higher nursing satisfaction, making it worthy of promotion.
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  • 文章类型: Journal Article
    OBJECTIVE: This research quantitatively explored the prevalence of NANDA-I nursing diagnoses related to the care of patients experiencing heart failure.
    METHODS: A systematic review and meta-analysis were conducted with the systematic review protocol registered in PROSPERO (registration number: CRD42022382565).
    METHODS: Systematic searches were performed between March and April 2022, including peer review for selection, quality assessment, data extraction, and analysis of all included studies. A subsequent meta-analysis was performed, focusing on the proportion of nursing diagnoses in patients with heart failure. The logistic random effects model with maximum likelihood estimation assessed the combined proportion, and heterogeneity between studies was evaluated using the I2 statistic. The goodness-of-fit of the meta-analysis results was assessed using the leave-one-out method and by evaluating publication bias through contour-enhanced funnel plots.
    METHODS: PubMed, SCOPUS, CINAHL, WOS, and Embase were used.
    RESULTS: Of the 11 studies that met the eligibility criteria, 44 nursing diagnoses were identified as most frequently occurring in patients experiencing heart failure, and only 16 diagnoses appeared in more than one publication. The combined mean proportion was 35.73% (95% CI = [26.67%; 48.56%]), indicating the presence of heterogeneity based on the I2 value. However, no publication bias was observed.
    CONCLUSIONS: The results of the meta-analysis suggest priority diagnoses in individuals with heart failure, such as deficient knowledge (00126). Additionally, secondary diagnoses, such as activity intolerance (00092), excess fluid volume (00026), and ineffective breathing pattern (00032), were identified as responses to decreased cardiac output (00029). Less prevalent nursing diagnoses were associated with deterioration of health status and the need for hospitalization.
    OBJECTIVE: Investigar cuantitativamente la prevalencia de diagnósticos de enfermería NANDA-I asociados con la atención de pacientes con insuficiencia cardíaca. DISEÑO: Revisión sistemática y metanálisis. El protocolo de revisión sistemática quedó registrado en PROSPERO) número de registro: CRD42022382565). MÉTODOS: Se realizaron búsquedas sistemáticas entre marzo y abril de 2022, llevándose a cabo una revisión por pares sobre la selección, evaluación de calidad, extracción de datos y análisis de todos los estudios incluidos. Se realizó un metanálisis posterior centrado en la proporción de diagnósticos de enfermería en pacientes con insuficiencia cardíaca. El modelo logístico de efectos aleatorios con estimación de máxima verosimilitud evaluó la proporción combinada y la heterogeneidad entre los estudios se evaluó mediante el estadístico I2. La bondad de ajuste de los resultados del metanálisis se evaluó mediante el método Leave-one-out y la evaluación del sesgo de publicación mediante gráficos de embudo (funnel plot), denominado Contour-Enhanced Funnel Plot.
    UNASSIGNED: PubMed, SCOPUS, CINAHL, WOS, Embase.
    RESULTS: En los 11 estudios que cumplieron con los criterios de elegibilidad, se identificaron 44 diagnósticos de enfermería aunque sólo 16 diagnósticos aparecieron en más de una publicación. La proporción media combinada fue del 35,73% (IC del 95%) = [26,67%; 48,56%]), y el valor de I2 indica la presencia de heterogeneidad, aunque no hay sesgo de publicación. CONCLUSIÓN: Los resultados de este metaanálisis indican que habría diagnósticos prioritarios en personas con insuficiencia cardíaca, como Conocimientos deficientes (00126). Además, se han identificado otros diagnósticos de enfermería como diagnósticos secundarios: Intolerancia a la actividad (00092), Exceso de volumen de líquidos (00026) y Patrón respiratorio ineficaz (00032), que sería la respuesta a Disminución del gasto cardíaco (00029). Además de diagnósticos de enfermeríaa menos prevalentes relacionados con el deterioro del estado de salud y la necesidad de hospitalización.
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  • 文章类型: Journal Article
    目的:总结颅脑损伤患者认知功能障碍的最佳循证管理策略,为临床护理实践提供参考。
    方法:审查。
    方法:使用PRISMA指南进行了综述。在计算机决策系统中对脑损伤患者认知功能障碍的管理进行了系统的证据搜索,指南网站,专业协会网站和综合数据库自创建之日起至2023年6月21日。包括的证据类型是临床决策,指导方针,证据摘要,最佳实践,建议的做法,专家共识,系统评价和荟萃分析。两名在循证方法论系统中接受培训的研究人员独立评估了文献的质量,并提取了文献,对纳入的证据进行整合和分级。
    结果:共选取20篇文章,包括九项准则,三篇专家共识文章,一篇临床实践文章和七篇系统综述,文献总体质量较高。在七个方面总结了30条证据:评估,多学科团队,康复计划,认知干预,运动干预,音乐干预和药物管理。
    结论:本研究总结了成人颅脑损伤患者护理中认知功能障碍管理的最新证据,为临床护理实践提供参考。在临床工作中,应选择最佳证据进行局部化、个体化应用,最好的证据应该不断更新,以规范护理实践。
    脑损伤后出现认知障碍的患者常出现记忆力减退,注意力不足和迷失方向,无法过正常的生活和体验很多享受,这严重影响了他们的身心健康,给他们的家庭和社会造成了巨大的负担。基于证据的颅脑损伤认知障碍护理管理的最佳策略对于规范临床护理实践和及时提供,专业,对患者进行系统全面的护理干预。
    这项审查是根据PRISMA2020声明指南报告的,如适用,提高证据综合报告的透明度。
    本研究已在复旦大学循证护理中心注册,JBI卓越中心,注册号为ES20232566,http://ebn。护理。福丹。edu.cn/myRegisterList。
    没有患者或公众捐款。
    OBJECTIVE: To summarize the best evidence-based strategies for the management of cognitive dysfunction in patients with brain injury and to provide a reference for clinical nursing practice.
    METHODS: Review.
    METHODS: The review was presented using PRISMA guidelines. A systematic search of evidence on the management of cognitive dysfunction in patients with brain injury was conducted in computerized decision systems, guideline websites, professional association websites and comprehensive databases from the date of creation to 21 June 2023. The types of evidence included were clinical decision making, guidelines, evidence summaries, best practices, recommended practices, expert consensus, systematic reviews and meta-analyses. Two researchers trained in evidence-based methodological systems independently evaluated the quality of the literature and extracted, integrated and graded the evidence for inclusion.
    RESULTS: A total of 20 articles were selected, including nine guidelines, three expert consensus articles, one clinical practice article and seven systematic reviews, and the overall quality of the literature was high. Thirty pieces of evidence were summarized in seven areas: assessment, multidisciplinary team, rehabilitation program, cognitive intervention, exercise intervention, music intervention and medication management.
    CONCLUSIONS: This study summarizes the latest evidence on the management of cognitive dysfunction in the care of adults with brain injury and provides a reference for clinical nursing practice. The best evidence should be selected for localized and individualized application in clinical work, and the best evidence should be continuously updated to standardize nursing practice.
    UNASSIGNED: Patients with cognitive impairment after brain injury often suffer from memory loss, attention deficit and disorientation and are unable to have a normal life and experience much enjoyment, which seriously affects their physical and mental health and creates a great burden of care for their families and society. Best evidence-based strategies for the nursing management of cognitive impairment in brain injury are essential for standardizing clinical nursing practice and providing timely, professional, systematic and comprehensive nursing interventions for patients.
    UNASSIGNED: This review is reported following the PRISMA 2020 statement guidelines, as applicable, to enhance transparency in reporting the evidence synthesis.
    UNASSIGNED: This study has been registered with the Fudan University Centre for Evidence-based Nursing, a JBI Centre of Excellence under registration number ES20232566, http://ebn.nursing.fudan.edu.cn/myRegisterList.
    UNASSIGNED: No patient or public contribution.
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  • 文章类型: Journal Article
    目的:目的是探索一线护士管理者对支持循证护理的机会和障碍的经验。
    方法:采用现象学方法的定性研究。
    方法:数据是通过焦点小组访谈收集的,在四种情况下对15名一线护士管理者进行访谈。
    结果:结果分为四类,标题为:管理日常工作与循证护理;循证护理和护理研究的不确定性;时间为现实,作为一种方法;和塑造意识-建立积极的循证护理方法。描述的总体类别如下:内在联系-积极领导如何影响循证护理。结果空间表示为:个人路径-如何使视觉和现实成为围绕循证护理的工作实体。
    OBJECTIVE: The aim was to explore first line nurse managers\' experiences of opportunities and obstacles to support evidence-based nursing.
    METHODS: A qualitative study with a phenomenographical approach.
    METHODS: Data were collected through focus group interviews with 15 first line nurse managers\' in four settings.
    RESULTS: The results are presented in four categories of description headed: Manage the everyday work vs. evidence-based nursing; Uncertainties about evidence-based nursing and nursing research; Time as a reality, as an approach; and Shaping awareness-towards an active approach to evidence-based nursing. The overarching category of description has been formulated as follows: The internal relation-how active leadership influences evidence-based nursing. The outcome space is presented as: The individual path-how to make vision and reality become a working entity around evidence-based nursing.
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