基于JBI临床证据实践应用系统的老年COPD患者氧疗管理实践

Management on oxygen therapy for old COPD patients based on JBI practical application of clincial evidence system

目的提高老年科护士对COPD患者的氧疗管理效果,提高护士对氧疗管理实践活动中证据应用的依从性,增加患者持续氧疗时间,提高患者的血氧饱和度。方法遵循JBI循证保健中心的临床证据实践应用系统(JBI-PACES)的实践程序(GRIP),基于现有的最佳证据,制定了9条审查标准,对20名护士进行培训,在对30例老年COPD氧疗患者进行基线审查后,查找最佳证据应用于30例老年COPD氧疗患者和再审查。结果与基线审查结果比较,证据应用后9条审查标准中7条执行率显著提高(均P<0.01);患者的氧疗时间显著增加、血氧饱和度显著提升(均P<0.01)。结论 COPD氧疗管理最佳证据的应用,可规范临床护士对COPD患者氧疗的护理实践,增加患者持续氧疗时间,提高患者血氧饱和度。

Objective To enhance nurses＇ management effect on oxygen therapy for COPD patients in geriatric department, and to improve nurses＇ adherence to the evidence application in the practice of oxygen therapy management, and to increase patients＇ dura tion of oxygen therapy and their blood oxygen saturation. Methods Nine audit criteria were developed based on the available best evidence and adhered to the Joanna Briggs Institute＇s practical application of clincial evidence system （JBI-PACES） and Getting Research into Practice （GRIP）. A training program was provided for 20 nurses, and a baseline audit was conducted on 30 old COPD patients undergoing oxygen therapy, then the best evidences were identified and put into practice and a follow-up audit was conducted on the 30 patients. Results Compliance with seven of the nine evidence-based recommendations was significantly increased in the reaudit compared with the baseline audit （P〈0.01 for all）. The duration of oxygen therapy and patients＇ blood oxygen saturation were significantly increased （P〈0.01 for both）. Conclusion Application of the best evidence on oxygen therapy management for COPD patients, could regulate clinical nurses＇ practice of oxygen therapy for COPD patients, increase patients＇ duration of oxygen therapy and improve their blood oxygen saturation.