目的 评价成人机械通气患者误吸预防的最佳证据的应用效果。方法 运用循证护理方法将机械通气患者误吸预防的最佳证据制订成循证实践方案,经过基线审查、障碍因素分析,构建最佳证据应用策略,并于2022年10月1日—11月20日在杭州市某三级甲等医院急诊监护室实施最佳证据,比较循证实践前后患者误吸发生率、审查指标的执行率,以及护士对机械通气患者误吸预防管理知识问卷得分。结果 最终纳入23条证据,19条审查指标。循证实践后机械通气患者误吸的发生率从21.43%下降到6.67%,呼吸机相关性肺炎的发生率从28.57%下降到6.67%;除审查指标10、19外,其余审查指标的执行率均上升至90%以上;护士对机械通气患者误吸预防管理知识问卷得分从（78.04±1.58）分上升到（91.04±0.98）分,差异具有统计学意义（t=-11.879,P<0.001）。结论 将基于循证的最佳证据应用于临床护理实践,有利于防止机械通气患者误吸的发生,提升临床护理质量。
Objective To summarize and evaluate the application effects of the best evidence of aspiration prevention in adult patients with mechanical ventilation. Methods The best evidence for the prevention of aspiration in patients with mechanical ventilation was developed into an evidence-based practice plan by using the method of evidence-based nursing. After baseline review,obstacle factor analysis,and construction of the best evidence application strategy,the best evidence was implemented in the emergency intensive care unit of a tertiary hospital in Hangzhou from October 1 to November 20,2022. The incidence of aspiration in patients before and after evidence-based practice,the implementation rate of review indicators,and the scores of emergency intensive care unit nurses on the knowledge questionnaire of aspiration prevention and management in patients with mechanical ventilation were compared. Results Finally,23 evidences were included and 19 review indicators were formed. After evidence-based practice,the incidence of aspiration in patients with mechanical ventilation decreased from 21.43% to 6.67%,and the incidence of ventilator-associated pneumonia（VAP）decreased from 28.57% to 6.67%. Except for indicator 10 and 19,the implementation rate of the other review indicators increased to more than 90%. The score of nurses' questionnaire on knowledge of aspiration prevention and management in patients with mechanical ventilation increased from （78.04±1.58）points to （91.04±0.98）points,and the difference was statistically significant（t=-11.879,P<0.001）. Conclusion Applying the best evidence to clinical nursing practice is conducive to reduce the incidence of aspiration in patients with mechanical ventilation,improve the quality of clinical nursing.
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