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目的将与维持性血液透析患者液体摄入依从性管理有关的最佳证据应用于临床护理实践,提高血液透析患者液体摄入控制依从性。方法将JBI临床证据实践应用系统和临床转化系统作为审查工具,基于现有的血液透析患者液体摄入依从性管理的最佳证据,制定5条审查标准。对20名护士、30例患者实施基线审查和证据应用后第2轮审查。结果基线审查时4条标准执行率较差(0~55.0%),第2轮审查时,第3条审查标准(患者自我监测液体摄入)执行率73.3%,其余4条审查标准执行率均100%。护士液体摄入管理知识和技能得分从12.70提高到14.60(P<0.01);血液透析患者液体摄入知识和技能得分从11.13分提高到13.47分(P<0.01),其液体摄入控制不依从率从53.33%降低至23.33%(P<0.05)。结论基于循证的质量审查改善维持性血液透析患者液体摄入依从性管理的临床护理实践,可提高患者液体摄入控制依从性。
OBJECTIVE: To apply best evidence related to compliance with fluid intake in maintenance hemodialysis patients to clinical practice and to improve compliance with fluid intake control in hemodialysis patients. Methods JBI Clinical Evidence Practice Application System and Clinical Translation System were used as a review tool to develop five review criteria based on the best available evidence of compliance with liquid ingestion for hemodialysis patients. A total of 20 nurses and 30 patients underwent baseline review and evidence review after the second round of application. Results The implementation rate of 4 standards at baseline was poor (0-55.0%). At the second round of review, the implementation rate of Article 3 review standard (patient self-monitoring liquid intake) was 73.3% 100%. The knowledge and skill score of nurses’ liquid intake management increased from 12.70 to 14.60 (P <0.01); the knowledge and skill scores of liquid intake in hemodialysis patients increased from 11.13 to 13.47 (P <0.01), and the control of liquid intake did not comply The rate decreased from 53.33% to 23.33% (P <0.05). Conclusion Evidence-based quality reviews that improve clinical adherence to fluid compliance management in maintenance hemodialysis patients may improve compliance with fluid intake control.