ICU谵妄集束化护理干预方案的构建

Construction of the cluster nursing program of delirium in ICU

目的构建基于循证医学的集束化护理干预方案,降低ICU谵妄发生率。方法采用国际通用循证医学中的格式(PICO)提出循证问题,检索2000-2016年JBI循证卫生保健国际合作中心图书馆(Joanna Briggs Institute Library)、Cochrane图书馆、Pub Med、CINAHL、CBM、CNKI中针对ICU谵妄护理干预的研究,根据纳入标准筛选文献、提取资料并进行质量评价。结果共检索出随机对照试验文献6篇、半随机对照试验文献2篇、自身对照试验文献2篇、病例对照试验文献1篇。根据检索结果结合临床应用,构建ICU谵妄集束化护理方案。结论该方案包括每日唤醒计划、早期功能锻炼、降低声光刺激、提供定向刺激四项措施。该方案基于循证医学,它的实施对降低ICU谵妄患者死亡率、改善预后、缩短平均住院日有重要意义。

Objective To construct the cluster nursing program of evidence - based medicine to reduce the incidence of deliri- um in ICU. Methods The related studies in Joanna Briggs Institute Library, Cochrane library, PubMed, CINAHL, CBM, CNKI from 2000 to 2016 were selected and evaluated the quality according the inclusion and exclusion criteria to raise the evidences based on the PICO format and raised the questions. Results Searched studies included 6 of randomized controlled trials （ RCTs）, two of semi - randomized controlled trials （ RCTs）, two of self - controlled trials, and one case - control trials for delirium in ICU. The cluster nursing program of delirium in ICU was constructed according to the retrieval results combined with clinical application. Conclusion The program has im- portant significance to implent the scheme for reducing delirium in ICU mortality, it can improve the prognosis and shorten the average hospitalization day because of evidence -based medicine.