成人输液港置入与维护的最佳证据

Summary of the best evidences for the placement and maintenance of adult infusion ports

目的总结成人输液港置入与维护的最佳证据,为临床医护人员在输液港置入与维护时提供依据。方法运用PIPOST模式创建循证问题,按照“6S”证据分层模型,检索UpToDate、BMJ Best Practice、Cochrane Library、JBI循证卫生保健中心数据库、美国国立指南库(NGC)、美国疾病预防与控制中心(CDC)、英国国家临床医学研究所指南库(NICE)、国际指南协作网(GIN)、加拿大安大略注册护士协会(RNAO)、CINAHL、EMbase、PubMed、美国静脉输液护理学会(INS)、万方、知网、维普、SinoMed、医脉通等数据库。检索时间为建库至2023年7月6日。两名接受过循证专业培训的科研人员分别对文献进行质量评价,遴选、归纳证据。结果最终纳入12篇文献,包括临床决策分析1篇,专家共识5篇,临床实践指南与证据总结各3篇。分析纳入的文献,筛选证据96条,最终整合汇总为66条证据,分别为:人员资质、适应证及禁忌证、围术期护理、PORT维护、健康教育等5个维度。结论临床医护人员应根据证据制定符合实际情况的护理策略,提高成人患者输液港置入及维护的安全。

Objective To summarize the best evidences for the placement and maintenance of adult infusion ports,and to provide a basis for clinical medical staff to carry out the placement and maintenance of infusion ports.Methods The evidence-based questions were constructed using PIPOST mode.According to the"6S"classification model of evidence,a computerized retrieval of academic papers concerning the best evidence for the placement and maintenance of adult infusion ports from the databases of UpToDate,BMJ Best Practice,Cochrane Library,JBI evidence-based healthcare center database,National Guidelines Clearinghouse(NGC),Center for Disease Control and Prevention(CDC),National Institute for Health and Care Excellence(NICE),Guidelines International Network(GIN),the Registered Nurses'Association of Ontario(RNAO),CINAHL,EMbase,PubMed,Intravenous Nurses Society(INS),Wanfang,CNKI,VIP,SinoMed and Yimaitong was conducted.The retrieval time period was from the establishment of the database to July 6,2023.Two researchers,who had received training in evidencebased nursing,independently evaluated the quality of the literature,screened and summarized the evidences.Results A total of 12 papers,including one paper of clinical decision analysis,5 papers of expert consensus,3 papers of clinical practice guideline,and 3 papers of evidence summary,were finally enrolled in this study.A total of 96 pieces of evidence were extracted from the included literature,and 66 pieces of evidence were ultimately synthesized,which were classified into 5 dimensions,including personnel qualifications,indications and contraindications,perioperative care,PORT maintenance,and health education.Conclusion Clinical healthcare professionals should formulate the nursing strategies based on the evidence so as to improve the safety of infusion port placement and maintenance in adult patients.