急危重症患者外周静脉通路建立相关指南的质量评价及内容分析

doi:10.16460/j.issn1008-9969.2022.13.039

摘要/Abstract

摘要： 目的对国内外急危重症患者外周静脉通路建立相关指南进行质量评价和内容分析,为临床开展以证据为基础的急危重症患者外周静脉通路建立工作提供指导。方法检索中国知网、万方数据库、PubMed、Web of Science数据库、各指南网站及相关协会发布的急危重症患者外周静脉通路建立相关指南、专家共识或标准,运用指南研究与评估系统（AGREE Ⅱ）对纳入的循证指南进行质量评价,采用JBI循证卫生保健中心的专家共识评价标准对专家共识指南进行评价,采用内容分析法对纳入指南的相关推荐意见进行分析、汇总和归类。结果最终纳入16篇指南,其中循证指南11篇、专家共识5篇;11篇循证指南中 6篇被评价为A,5篇被评价为B,5篇专家共识总体评价结果为“纳入”纳入指南共总结出通路选择、置管部位、穿刺次数、舒适护理、辅助技术及导管维护等12个主题。结论纳入指南总体质量较高,推荐意见对临床实践有一定指导意义,但部分循证指南的严谨性、应用性及独立性领域仍需要进一步完善;国内指南以专家共识为主,需结合我国文化背景构建急危重症患者外周静脉通路建立的循证指南。

关键词: 急危重症患者, 外周静脉通路, 临床实践指南, AGREE Ⅱ, 内容分析法

Abstract: Objective To analyze the content and evaluate the quality of the guidelines related to peripheral venous access placement for critically ill patients at home and abroad, and to provide guidance for evidence-based clinical practice of peripheral venous access placement for critically ill patients. Methods The guidelines, expert consensus or standards regarding the placement of peripheral venous access for critically ill patients were searched in CNKI, Wangfang Data, PubMed, Web of Science, and websites of related associations. The Appraisal of Guidelines for Research & Evaluation Ⅱ (AGREE Ⅱ) was used to evaluate the quality of the included evidence-based guidelines, and expert consensus-based guidelines were evaluated using expert consensus evaluation criteria from JBI Evidence-based Health care centers. Content analysis was used to analyze, summarize and classify the recommendations included in the guidelines. Results Sixteen guidelines were collected, including 11 evidence-based guidelines, and 5 expert consensus-based guidelines. Among the 11 evidence-based guidelines, 6 were rated as A, and 5 as B. The overall evaluation result of 5 expert consensus-based guidelines was "included". Twelve topics, including access selection, placement site, puncture frequency, comfort care, assistive technology and catheter maintenance were summarized in the guidelines. Conclusion The overall quality of the included guidelines is high, and the recommendations have certain guiding significance for clinical practice. However, the rigor, applicability and independence of some evidence-based guidelines still need to be further improved. Expert consensus dominates domestic guidelines, and evidence-based guidelines for establishing peripheral venous access in critically ill patients should be compiled based on Chinese cultural background.

Key words: emergency and critical patient, peripheral venous access, clinical practice guidelines, AGREE Ⅱ, content analysis

中图分类号:

R473

杜玫洁, 张娜, 李咪琪, 黄素芳. 急危重症患者外周静脉通路建立相关指南的质量评价及内容分析[J]. 护理学报, 2022, 29(13): 39-45.

DU Mei-jie, ZHANG Na, LI Mi-qi, HUANG Su-fang. Quality Evaluation and Content Analysis of Clinical Practice Guidelines Regarding Peripheral Venous Access Placement in Emergency and Critical Patients[J]. Journal of Nursing, 2022, 29(13): 39-45.

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