危重病人血糖控制:最佳实践实施项目。

IF 2.7 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Mengjuan Jing, Fan Yan, Hao Li, Chunpeng Li, Xiaojing Wei, Weihua Liu, Liming Li, Hongmei Zhang
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引用次数: 0

摘要

导读:已有研究表明,重症监护病房(icu)中约有一半的危重患者存在血糖异常。高血糖和低血糖均可增加危重症患者的死亡风险;因此,控制这类患者的血糖至关重要。临床实践与目前ICU血糖控制的最佳证据之间存在显著差距。目的:本最佳实践实施项目旨在通过推广最佳实践,改善中国某三级医院危重患者的血糖控制。方法:本项目根据基于审计和反馈策略的JBI证据实施框架进行。为基线和后续审计制订了四项审计标准。根据基线审计中确定的障碍和促进因素设计了实现协议。来自患者医疗记录和护士访谈的护理文件被用来评估基线和随访审计依从率。结果:在后续审核中,对四项标准的符合性有所提高。除了标准2略有改善(从15.3%增加到26.6%),其他三个标准都取得了显著的改善。标准1的符合率从43.8%增加到70.0%,标准3从0%增加到100%,标准4从46.8%增加到65.8%。结论:该循证实施项目成功地提高了护士对危重患者血糖控制最佳实践建议的依从性。西班牙文摘要:http://links.lww.com/IJEBH/A338。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Glycemic control in critically ill patients: a best practice implementation project.

Introduction: Prior studies have shown that about half of critically ill patients in intensive care units (ICUs) have abnormal blood glucose. Both hyperglycemia and hypoglycemia increase the risk of death in critically ill patients; therefore, controlling blood glucose in such patients is crucial. There is a significant gap between clinical practice and the current best evidence regarding glycemic control in ICU.

Aim: This best practice implementation project aimed to improve glycemic control for critically ill patients in a tertiary hospital in China by promoting best practices.

Methods: This project was conducted according to the JBI Evidence Implementation Framework, which is based on an audit and feedback strategy. Four audit criteria were developed for the baseline and follow-up audits. An implementation protocol was designed based on the barriers and facilitators identified in the baseline audit. Nursing documentation from patients' medical records and interviews with nurses were used to assess the baseline and follow-up audit compliance rates.

Results: The results showed improved compliance with the four criteria in the follow-up audit. Except for only slight improvement in Criterion 2 (increasing from 15.3% to 26.6%), the three other criteria all achieved significant improvements. The compliance rate for Criterion 1 increased from 43.8% to 70.0%, Criterion 3 increased from 0% to 100%, and Criterion 4 increased from 46.8% to 65.8%.

Conclusions: This evidence-based implementation project successfully increased nurses' compliance with best practice recommendations for glycemic control in critically ill patients.

Spanish abstract: http://links.lww.com/IJEBH/A338.

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来源期刊
CiteScore
3.20
自引率
13.00%
发文量
23
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