成人密闭式吸痰装置临床应用的最佳证据总结

Summary of best evidence for clinical use of closed tracheal suction systems devices in adults

目的检索、评价并总结国内外成人密闭式吸痰安全性及应用的相关证据,为临床护理工作提供参考。方法检索BMJ Best Practice、UpToDate、Joanna Briggs Institute循证卫生保健中心数据库、国际指南协作网、英国国家临床医学研究所指南库、苏格兰院际指南网、加拿大安大略注册护士协会、美国呼吸道护理协会、美国重症医学会、医脉通、Cochrane Library、PubMed、Embase、CINAHL、中国知网、万方数据库、中国生物医学文献数据库中相关的指南、系统评价、专家共识、最佳实践等。检索时限为建库至2021年2月28日。由2名研究人员对纳入的文献质量进行独立评价,并对符合质量标准的文献进行证据提取和汇总。结果共纳入20篇文献,其中临床决策3篇、指南2篇、系统评价11篇、专家共识4篇。从使用指征、临床效果、安全性、使用方法、更换5个方面汇总了27条最佳证据。结论本研究总结了关于成人密闭式吸痰装置临床应用的最佳证据,临床护理人员在应用证据时需结合临床环境有针对性地选择最佳证据,以规范密闭式吸痰装置的临床应用。

Objective To search,evaluate and summarize the evidence of the safety and application of closed tracheal suction systems and to provide reference for clinical nursing work.Methods BMJ Best Practice,UpToDate,Joanna Briggs Institute Evidence-based Health Care Center,Guidelines International Network,National Institute for Health and Care Excellence,Scottish Intercollegiate Guidelines Network,Registered Nurses'Association of Ontario,American Assocition for Respiratory Care,Society of Critical Care Medicine,Medlive,Cochrane Library,PubMed,Embase,CINAHL,CNKI,Wanfang Database,China Biology Medicine disc were searched for related guidelines,system reviews,expert consensus,best practices,etc.The retrieval time was from the database construction to February 28,2021.Two researchers independently evaluated the quality of the included literature and extracted and summarized the evidence of the literature that met the quality standards.Results A total of 20 literatures were included,including 3 clinical decisions,2 guidelines,11 systematic reviews and 4 expert consensuses.A total of 27 pieces of best evidence were compiled from five aspects,including indications for use,clinical effects,safety,methods of use and replacement.Conclusions This study summarizes the best evidence on the clinical application of closed sputum suction devices in adults.When applying the evidence,clinical nurses need to select the best evidence in combination with the clinical environment to standardize the clinical application of closed tracheal suction systems.