脑肿瘤患者围术期深静脉血栓非药物预防的循证护理实践

Evidence-based nursing practice for non-pharmacological prevention of perioperative deep vein thrombosis in patients with brain neoplasms

目的 探讨基于最佳证据的脑肿瘤患者围术期深静脉血栓(DVT)非药物预防方法并评价其应用效果。方法 以“基于证据的持续质量改进模式”为指导,于2021年4-9月,按照证据获取、现状审查、证据引入和效果评价4个阶段将循证实践应用于脑肿瘤围术期患者,比较循证实践应用前后患者DVT发生率等指标的变化。结果 总结19条静脉血栓非药物预防证据并把证据转化为34条审查指标开展循证实践,脑肿瘤围术期DVT预防审查指标执行率及护士DVT相关知识、态度、行为水平明显提高,其中知识、行为维度差异具有统计学意义(P<0.05)。DVT发生率由10.75%降低到4.05%(P=0.020),患者知识得分由(14.00±2.14)分提高至(22.00±2.87)分(P<0.001)。结论 通过开展脑肿瘤围术期DVT非药物预防的循证实践,能有效改善临床实践环境,培养护士循证理念,提高其DVT预防知识、态度及临床措施依从性,提升患者预防知识水平,降低临床DVT发生率。

Objective To explore the best evidence-based non-pharmacological prevention method of perioperative deep vein thrombosis(DVT)in patients with brain tumor,and to evaluate its application effect.Methods Guided by the"Evidence-Based Continuous Quality Improvement Model",evidence-based practice was applied to perioperative patients with brain tumors according to 4 stages of evidence acquisition,status review,evidence introduction,and effect evaluation from April to September 2021.The changes in the incidence of DVT and other indicators of patients before and after the application of evidence-based practice were compared.Results A total of 19 evidence for non-pharmacological prevention of perioperative venous thrombosis were summarized and transformed into 34 review indicators for evidence-based practice.The implementation rate of review indicators for prevention of DVT during perioperative period of brain tumor and nurses'DVT-related knowledge,attitude,and behavior levels were significantly improved,and the differences in knowledge and behavior dimensions were statistically significant(both P<0.05).The incidence of DVT decreased from 10.75%to 4.05%(P=0.020),and the patient knowledge score increased from(14.00±2.14)points to(22.00±2.87)points(P<0.001).Conclusion The evidence-based practice of non-pharmacological prevention of perioperative DVT in patients with brain neoplasms,clinical environment can effectively improve the clinical practice environment,cultivate the evidence-based concept of nurses,and improve their knowledges,attitudes,and compliances with clinical measures,promote patients'prevention knowledge level,and reduce the incidence of clinical DVT.