脑卒中住院病人口腔护理的循证实践

Evidence-based practice of oral care for stroke inpatients

[目的]制订和应用脑卒中住院病人口腔护理的最佳循证实践方案,规范护理人员口腔护理实践行为,提高口腔护理效果。[方法]结合最佳证据和情景分析,形成脑卒中住院病人口腔护理的最佳循证实践方案和脑卒中住院病人口腔护理标准护理流程,并将证据应用于神经内科病房脑卒中住院病人。审查小组制定了5条审查指标,对35名护士及30例脑卒中住院病人进行基线审查,经过对护理人员进行培训和开展临床实践3个月后进行第2轮审查。[结果]两轮审查显示,35名护士接受系统的口腔护理方案培训,行为依从率从11.43%～57.14%升至100.00%,质量审查前后病人口腔卫生评分比较差异有统计学意义(P<0.05)。[结论]基于循证的质量审查项目可以改善护士应用最佳证据的执行行为,有效提高脑卒中住院病人的口腔护理效果。

Objective:To formulate and apply the best evidence-based practice scheme of oral care for stroke inpatients,standardize the oral care practice behavior of nursing staff,and improve the effect of oral care.Methods:Combining the best evidence and scenario analysis,the best evidence-based practice scheme and the standard nursing process of oral care for stroke inpatients were formed,and the evidence was applied to stroke inpatients in the neurology ward.The review team made 5 review indicators,conducted a baseline review of 35 nurses and 30 stroke inpatients,and conducted a second round of review 3 months after nurse training and clinical practice.Results:Two rounds of examination showed that 35 nurses received systematic oral care program training and the behavioral compliance rate increased from 11.43%~57.14%to 100.00%.The difference was statistically significant in oral health score between patients before and after the quality examination(P<0.05).Conclusions:Evidence-based quality review programs could improve nurses′performance by the best evidence and effectively improve the oral care effect of stroke inpatients.