以目标为导向的急诊科严重创伤儿童体温管理:循证实践项目。

IF 2.7 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Jbi Evidence Implementation Pub Date : 2024-06-25 DOI:10.1097/XEB.0000000000000439
Wenchao Wang, Yanhong Zhang, Fang Ling, Shenjie Hu, Ying Gu
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引用次数: 0

摘要

导言和目标:体温过低通常发生在创伤患者身上。在急诊科,并非所有医务人员都严格遵守以证据为基础的低体温预防措施。本研究旨在评估一家中国医院中严重创伤儿童目标导向体温管理的循证实践的遵从情况:方法:该项目采用了JBI证据实施框架,将证据转化为实践。方法:该项目采用JBI证据实施框架,将证据转化为实践,并采用卫生服务研究实施综合促进行动(i-PARIHS)框架来识别最佳实践的遵从障碍。根据识别出的障碍,为创伤患者制定了以目标为导向的体温管理策略,并提供了模拟培训模块和保暖材料。通过实地观察、查阅医疗记录、采访医务人员和患者,对最佳实践的基线和后续审核遵守情况进行了评估:在基线和后续审核中,分别对 11 名和 37 名创伤患者的 12 项标准进行了审核。在后续审核中,所有标准的合规性都有所提高,颤抖和寒冷不适的评分有所下降。除两名死亡患者外,其他患者均未出现体温过低的情况:结论:使用 JBI 证据实施框架成功地提高了最佳实践的合规性。今后应进行审计,以维持所有医务人员的循证行为。西班牙文摘要:http://links.lww.com/IJEBH/A234。
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Goal-oriented temperature management in severely traumatized children in the emergency department: an evidence-based practice project.

Introduction and objectives: Hypothermia commonly occurs in trauma patients. Evidence-based practices for hypothermia prevention are not strictly followed by all medical staff in the emergency department. This study aimed to assess compliance with evidence-based practices regarding goal-oriented temperature management for severely traumatized children in a Chinese hospital.

Methods: This project used the JBI Evidence Implementation Framework to translate evidence into practice. The Integrated-Promoting Action on Research Implementation in Health Services (i-PARIHS) framework was used to identify barriers to compliance with best practices. A goal-oriented temperature management strategy for trauma patients was developed based on the identified barriers, along with a simulation training module, and the supply of warming materials. Field observation, review of medical records, and interviews with medical staff and patients were used to assess baseline and follow-up audit compliance with best practices.

Results: Twelve criteria were audited in the baseline and follow-up audits, with 11 and 37 trauma patients, respectively. In the follow-up audit, compliance with all criteria increased, with a reduction in shivering and cold discomfort scores. Except for two patients who died, hypothermia did not occur in any of the patients.

Conclusions: The JBI Evidence Implementation Framework was used to successfully improve compliance with best practices. Future audits should be conducted to sustain the evidence-based behavior of all medical staff.

Spanish abstract: http://links.lww.com/IJEBH/A234.

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CiteScore
3.20
自引率
13.00%
发文量
23
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