脊柱骨科术后患者深静脉血栓预防及管理证据应用审查及障碍分析

Application review and obstacle analysis of evidence for prevention and management of deep vein thrombosis in patients after spinal orthopedic surgery

目的了解脊柱骨科术后患者深静脉血栓预防及管理护理证据临床应用现状并分析其障碍因素,促进最佳证据在临床中的应用;构建深静脉血栓预防及管理的标准化流程以提高临床护理质量。方法纳入项目前期脊柱骨科术后深静脉血栓预防及管理护理证据24条,制定审查指标9条,进行护理实践临床审查,根据审查结果分析障碍因素,并制定改进对策。结果 9条审查指标临床执行率为0~100%,其中5条指标执行率<80%。障碍因素主要为深静脉血栓预防流程不完善、医护人员培训不足、缺乏有效健康宣教等。结论脊柱骨科术后患者深静脉血栓预防及管理的护理证据与临床实践有较大差异,应制定相应的改进措施,促进证据向临床的有效转化。

Objective To understand the clinical application status of evidence for the prevention and management of deep vein thrombosis in patients after spinal surgery, and to analyze the obstacle factors, promote the application of the best evidence in clinical practice, construct a standardized process for the prevention and management of deep vein thrombosis, and improve the quality of clinical nursing. Method 24 evidences of prevention and management of deep vein thrombosis after spinal surgery were included in the early stage of the project, 9 examination indicators were established, nursing practice and clinical review was conducted, obstacle factors were analyzed according to the examination results and improvement measures were formulated. Results The clinical execution rate of 9 review indicators was 0~100%, of which 6 indicators were less than 80%. The main obstacle factors were incomplete prevention process of deep vein thrombosis,inadequate training of medical staff, and lack of effective health education. Conclusion The evidence of prevention and management of deep vein thrombosis in patients after spinal surgery is quite different from clinical practice,and obstacle factors targeted improvement should be implemented to promote the transforming of the evidence to the clinic correctly and effectively.