眼部护理循证标准在重症监护患者中的应用

The utilization of Joanna Briggs Institute's evidence-based practice standards of eye care for intensive care patients

目的探索降低眼部并发症的护理循证实践方案。方法2011年5-7月，对ICU内意识障碍、行镇静治疗或使用机械通气超过2d的患者进行分阶段研究。根据澳大利亚乔安娜·布里格斯研究中心（JoannaBriggsInstitute，JBI）的标准，首先进行重症监护患者眼部护理的基线质量审查，然后实施JBI眼部护理循证实践方案，并进行干预后的质量审查。结果实施眼部护理循证实践方案后，在JBI眼部护理质量审查的7条标准中。4条标准的完成率得到极大提高。干预后重症监护患者结膜充血、结膜暴露和角膜暴露的发生率均较基线阶段明显降低（B〈0．05）。结论JBI眼部护理循证标准应用于重症监护患者，能降低患者眼部并发症，但仍需不断完善。

Objective To evaluate the feasibility and effectiveness of Joanna Briggs Institute＇s evidence-based practice standards of eye care in critically ill patients. Methods Firstly,a baseline assessment of eye care was conducted in critically ill patients with consciousness,sedation medication or mechanical ventilation for more than two days in the intensive care units. Then,the Joanna Briggs Institute＇s evidence-based practice standards of eye care were implemented. The feasibility and effectiveness were evaluated by using Practical Application of Clinical Evidence System （PACES） and SPSS software. Results After the implementation of evidence-based practice standards of eye care ,the qualified rates were significantly improved in four of the seven items. The incidence of conjunctival hyperemia,conjunctival exposure and corneal exposure was significantly reduced（P〈0.05）. Conclusions Joanna Briggs Institute＇s evidence-based practice standards of eye care are feasible and effective for critically ill patients. It can reduce the incidence of eye complications,but still needs to be further improved.