急诊护士中心静脉导管维护循证实践影响因素的质性研究

Qualitative study on influencing factors to implement the best practice of central venous catheter maintenance among emergency nurses

目的了解急诊护士在中心静脉导管维护证据应用中的促进与障碍因素,为完善变革、促进证据应用提供依据.方法采用立意取样,选取北京市某三级甲等医院急诊科11名护士进行半结构式访谈,以健康服务领域研究成果应用的行动促进综合框架为依据设计访谈提纲,应用Colaizzi七步分析法对访谈资料进行整理和分析.结果对访谈内容进行转录编码、摘录、解释,最终形成2个主题和7个亚主题.急诊护士中心静脉导管维护证据应用的促进因素包含护士对证据的信任、专业组成立、专项管理强化及证据应用成效;障碍因素包含环境简陋、工具种类复杂及患者经济情况限制.结论医院应营造良好的循证护理文化,以证据为基础,通过专业组及专项管理等方法加强证据的应用及推广,在证据应用过程中,不断增加促进因素,克服及改善障碍因素,促使证据在急诊护理中更好地应用.

Objective To explore the enablers and barriers in the evidence practice of central venous catheter maintenance among emergency nurses,and to provide a basis for promoting transformation and the evidence practice.Methods Using purposive sampling,11 nurses in the Emergency Department of general hospital were selected for a semi-structured interview.The interview outline was designed using Promoting Action on Research Implementation in Health Service Integrated Framework as the framework,and the interview data was analyzed using Colaizzi’s seven-step method.Results Two themes and seven sub-themes were finally formed after transcribing,coding,extracting,and explaining the content of the interview.Enablers to implement the evidence included the trust of nurses in evidence,the establishment of professional groups,the strengthening of special management and the effect of evidence application.The barriers included poor environment,complex types of tools,and economic limitation of patients.Conclusion Hospitals should establish a good evidence-based nursing practice culture,and strengthen the promotion and application of evidence through professional groups and special management methods based on evidence.In the process of evidence practice,they should increase the enablers and overcome the barriers continuously,facilitating the better practice of evidence in clinical emergency care.