预防动静脉内瘘失功的循证护理实践

Evidence-based nursing practice for preventing Arteriovenous Fistula dysfunction in hemodialysis patients

目的 :总结预防动静脉内瘘失功的循证证据,并对其临床应用效果进行评价。方法 :检索预防动静脉内瘘失功的国内外相关指南、专家共识和系统评价,并汇总最佳证据,构建循证实践方案。将循证实践方案应用于临床,并评价实施前后动静脉内瘘失功发生率、护士和患者相关知识的认知水平和审查指标执行率的变化。结果 :循证实践前后,患者发生动静脉内瘘失功差异无统计学意义(P=0.171);护士和患者相关知识得分在循证实践前后差异均有统计学意义(P<0.001);护士和患者对部分审查指标的执行率在循证实践前后差异具有统计学意义(P<0.001)。结论 :预防动静脉内瘘失功的循证护理实践能够提高护士和患者对相关知识的认知水平,促进动静脉内瘘失功预防措施的实施,从而有助于降低失功发生率。

Objective:To summarize the evidence-based evidence for the prevention of Arteriovenous Fistula(AVF) dysfunction,and to evaluate its clinical effects.Methods:We searched relevant guidelines,expert consensus and systematic reviews for the prevention of AVF dysfunction and summarized the best evidence to construct evidence-based practice program.The program was applied to clinical practice,and the incidence of AVF dysfunction,the cognitive level of nurses and patients related knowledge and the the change of examination item execution rate before and after implementation were evaluated.Results:Before and after evidence-based practice,there was no signifcant difference between the two groups on incidence of AVF dysfunction(P=0.171).There was a statistically signifcant difference between the two groups on the scores of knowledge questionnaire(P<0.001).There was a statistically significant difference between the two groups on nurses’and patients’implementation rates of review items(P<0.001).Conclusion:The evidence-based practice program for preventing AVF dysfunction can improve nurses’and patients’awareness of relevant knowledge,promote the implementation of preventive measures for AVF dysfunction,and further implementation will help to reduce the incidence of dysfunction.