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ICU患者身体约束临床实践指南的质量评价与分析

柳清霞 王薇 胡力云 王晋芳 沈意娜 王海妍 徐小菁 郭红   

  1. 北京中医药大学护理学院,100029 北京市(柳清霞,王晋芳,沈意娜,王海妍,徐小菁,郭红);中日友好医院护理部(王薇);首都医科大学基础医学院(胡力云)
  • 出版日期:2018-05-25 发布日期:2018-05-25

Evaluation of clinical practice guidelines of physical restraint of ICU patients

  • Online:2018-05-25 Published:2018-05-25

摘要: 目的:评价已发布的ICU患者身体约束相关临床实践指南的质量,综合分析指南推荐建议的共识,为规范我国ICU患者身体约束临床实践及相关指南制定提供参考依据。方法:检索国内外指南网、相关机构网站及数据库等,按照纳入和排除标准进行筛选,采用临床研究与评估工具(AGREE II)对指南进行质量评价。结果:共纳入4部临床实践指南,其中美国3部、加拿大1部。经AGREE II评价标准化得分高的三个领域为范围和目的(84.26±16.15) %、其次为清晰性(76.50±12.97) %、严谨性(66.97±21.14) %,得分低的三个领域为应用性(62.15±26.34) %、独立性(63.54±34.21) %、参与人员(63.54±20.36) %,4部指南总体评分均数为(4.94±1.30)。2部A级指南,2部B级指南。结论:ICU患者身体约束临床实践指南数量较少,总体质量较好,在指南制定中应用性、独立性及参与人员方面均有待改善。我国尚无ICU患者身体约束指南,可考虑将国外较成熟的指南引入临床,并根据我国目前临床环境进行本土化实践,作为指导临床身体约束护理的规范。

Abstract: Objective: To evaluate the guidelines of physical restraint of ICU patients, and provide information for the development of physical restraint guidelines in China. Methods: Search the guidelines from related organization website and database. Evaluate the guidelines using the AGREE II instrument. Results: Four clinical practice guidelines were included in this study, among which three were from the United States and one from Canada. The three areas of the guidelines had higher scores: scope and purpose (84.26±16.15)%, clarity of presentations (76.50±12.97)%, and preciseness (66.97±21.14)%. The other three areas had lower scores: applicability (62.15±26.34)%, editorial independence (63.54±34.21)%, participants (63.54±20.36)%. The average overall score is (4.94±1.30). Two guidelines were leveled A, while other two guidelines were leveled B. Conclusion: Few guidelines with physical restraint are detected. The guidelines for application, independence and participation need to be improved. No physical restraint guideline found in China. The guidelines from abroad may be introduced to assist clinical nursing practice, and provide information to develop new guideline of physical restraint according to the present clinical environment and practice policy in China.