急性伤口清洗最佳循证实践方案的构建及应用效果

Establishment and application effect of best evidence-based practice scheme for acute wound cleansing

目的构建急性伤口清洗最佳循证实践方案并评价其应用效果。方法(1)基于最佳证据总结,采用鱼骨图进行差距分析,寻找导致急性伤口清洗障碍或效果不佳的原因,构建急性伤口清洗最佳循证实践方案。(2)选择2017年4月至2018年4月收治的急性创伤患者207例作为对照组;再选择2018年5月至2019年4月收治的急性创伤患者224例作为观察组。对照组采用传统方法清洗伤口,观察组采用最佳循证实践方案清洗伤口,比较最佳循证实践方案实施前后伤口专科护士对伤口清洗相关知识的掌握情况,清洗时患者的伤口疼痛评分、伤口愈合时间、伤口感染率、患者对护理满意度。结果构建了急性伤口清洗最佳循证实践方案。最佳循证实践方案实施后,护理人员的急性伤口清洗知识考核得分较前提高(P<0.05)。观察组患者清洗伤口时疼痛评分和伤口感染率低于对照组,伤口愈合时间短于对照组,护理满意度优于对照组(均P<0.05)。结论急性伤口清洗最佳循证实践方案的实施有效促进了护理人员清洗操作技能的提升,获得了满意的急性伤口清洗结局。

Objective To establish the best evidence-based practice scheme for acute wound cleansing and to evaluate its application effect.Methods(1)Based on the best evidence summary,the fishbone diagram was employed to perform a gap analysis to find out the causes leading to the barriers to or poor effects of acute wound cleansing,and the best evidence-based practice scheme for acute wound cleansing was established.(2)A total of 207 patients with acute trauma,who were admitted to the hospital from April 2017 to April 2018,were selected as control group,and another 224 patients with acute trauma,who were admitted to the hospital from May 2018 to April 2019,were selected as observation group.The control group received wound cleansing using the traditional method,whereas the observation group received wound cleansing using the best evidence-based practice scheme.The mastering levels of the knowledge associated with wound cleansing of nurses specialized in wound care,patients′scores for wound pain at cleansing,the durations to wound healing,wound infection rates,and patients′satisfaction with care before and after the implementation of the best evidence-based practice scheme were compared.Results The best evidence-based practice scheme had been established.After the implementation of the best evidence-based practice scheme,nursing staff obtained higher scores in the exam of acute wound cleansing knowledge than the previous(P<0.05).The observation group yielded a lower score for pain at wound cleansing,a lower wound infection rate,shorter duration to wound healing,and better satisfaction with care as compared with the control group(all P<0.05).Conclusion The best evidence-based practice scheme for acute wound cleansing effectively facilitates the improvement of nursing staff′s cleansing operation skills and achieves satisfactory outcomes of acute wound cleansing.