ISSN 2096-7446 CN 10-1655/R
主管:中国科学技术协会
主办:中华护理学会

中华急危重症护理杂志 ›› 2024, Vol. 5 ›› Issue (2): 108-114.doi: 10.3761/j.issn.2096-7446.2024.02.002

• 论著 • 上一篇    下一篇

ICU清醒患者睡眠促进策略审查指标的制订及障碍因素分析

辜甜田 陈伟 李晓娟 陈俊希   

  • 出版日期:2024-02-10 发布日期:2024-02-20

Development of indicators for reviewing sleep promotion strategies in ICU awake patients and analysis of barrier factors

GU Tiantian,CHEN Wei,LI Xiaojuan,CHEN Junxi   

  • Online:2024-02-10 Published:2024-02-20

摘要: 目的 了解ICU清醒患者睡眠促进策略证据临床应用现状,分析障碍因素和促进因素,初步拟定变革策略,为证据的临床转化提供参考。 方法 通过前期证据总结,纳入21条最佳证据,并制订13条审查标准与22条审查条目进行临床审查,根据审查结果分析障碍因素及促进因素,制订变革策略。 结果 22条审查条目临床执行率为0~100%,且其中8条审查标准的执行率均为0,障碍因素主要为ICU护士睡眠管理知识缺乏、科室相关的制度和流程空白、病房环境设置不合理等,促进因素主要为研究者及其团队具备较好的证据转化能力、 科室管理者积极支持变革、医院建设人文病房的政策支持以及科室护士接受和支持变革的意愿强烈等。 结论 ICU清醒患者睡眠促进策略证据与临床实践尚存在较大差距,应全面、深入剖析障碍因素和促进因素,拟定科学、合理的变革策略,促进证据转化,为临床实践提供参考依据。

关键词: ICU患者, 睡眠促进, 审查指标, 障碍因素, 变革策略

Abstract: Objective To understand the current status of clinical application of the evidence on sleep promotion strategies for awake patients in ICU,analyze the barriers and facilitators,and initially formulate strategies for change,so as to provide references for the clinical translation of the evidence. Methods Through the pre-evidence summary,21 pieces of best evidence were included and 13 audit criteria with 22 audit indicators were developed for clinical audit,and based on the results of the audit,barriers and facilitators were analyzed and strategies for change were developed. Results The clinical implementation rate for the 22 audit indicators ranged from 0 to 100%,and 8 of the review entries had an implementation rate of 0 percent. The barrier factors were mainly the lack of knowledge of sleep management among ICU nurses,gaps in the relevant systems and processes in the department,and irrational settings in the ward environment,while facilitators were the good ability of the researcher and the team to translate the evidence,active support for change from the departmental administrators,the support of the hospital’s policy to build a humanistic ward,and the strong willingness of the nurses in the department to accept and support the change. Conclusion There is still a large gap between the evidence of sleep promotion strategies for awake patients in ICU and clinical practice,so a comprehensive and in-depth analysis of barrier and promotion factors should be conducted to formulate scientific and reasonable change strategies,promote the translation of evidence,and provide a reference basis for clinical practice.

Key words: ICU Patients, Sleep Promotion, Review of Indicators, Barrier Factors, Change Strategies