预防术中俯卧位患者面部压力性损伤的最佳证据总结

Best Evidence Summary for Protecting Prone Positioned Patients from Intraoperative Facial Pressure Injury

目的评价和总结预防术中俯卧位患者面部压力性损伤的最佳证据,为术中俯卧位患者面部压力性损伤的预防策略提供参考。方法应用循证护理方法,针对术中俯卧位患者的面部压力性损伤提出问题,计算机检索国内外医学数据库、指南库、循证资源库及相关专业协会网站,手工查阅相关专业书籍中关于预防术中俯卧位患者面部压力性损伤的指南、证据总结、最佳实践信息、系统评价及专家共识类文献,由2名研究者对文献质量进行评价和证据提取。结果共纳入6篇文献,其中指南4篇,证据总结2篇。经过评价,总结得出18条最佳证据,包括患者压力性损伤风险评估、压力性损伤预防措施、压力性损伤分类评估和质量管理4个方面。结论本研究总结了预防术中俯卧位患者面部压力性损伤的最佳证据,为临床形成专业、有效的预防策略提供参考。建议手术室护理人员应用证据时应根据所在医疗机构现有的环境、应用证据的促进及阻碍因素、患者意愿及偏好有针对性的选择和应用证据。

Objective To evaluate and summarize the best evidence regarding the prevention of intraoperative facial pressure injury in prone positioned patients and to provide relevant evidence for the prevention of intraoperative facial pressure injury.Methods By evidence-based nursing method,we proposed some questions on facial pressure injury in prone positioned patients during the surgery then we searched guidelines,evidence summary(ES),best practice information sheet(BPIS),system evaluation(SR),recommendedpractices(RP)of the prevention for intraoperative facial pressure injury in prone positioned patients in medical databases at home and abroad,related professional association websites,and professional books.Two researchers evaluated the literature quality and extracted the evidence independently.Results Six articles including 4guidelines and 2 evidence summary were involved and 4 items of best evidence and 18 pieces of best evidence were summarized,including risk assessment,prevention measures,pressure injury stage assessment and quality management.Conclusion This study summarizes the best evidence for the prevention of intraoperative facial pressure injuries in prone positioned patients,which provides professional and effective prevention strategies for clinical practice.It is suggested that the operating room nurses should take factors including medical environment,factors promoting and impeding the application of evidence,and the patient’s willingness and preference into consideration to use the best evidence.