关键词: 危重症；儿童；有创机械通气；循证实践；i-PARIHS框架

Abstract: Objective: To improve the assessment, routine maintenance and extubation process of invasive mechanical ventilation in critically ill children through the best evidence application of invasive mechanical ventilation in critically ill children, so as to reduce ventilator-associated pneumonia in critically ill children. Methods: According to the clinical evidence practice application mode of JBI evidence-based nursing center, a total of 17 best evidences were summarized, and 15 quality review indicators were formulated combined with clinical situation and professional judgment through systematic search and quality evaluation of literature related to invasive mechanical ventilation in critically ill children. The i-PARIHS evidence-based practice conceptual framework was used to analyze the obstacles and formulate the action plan. Results: After two rounds of audit, medical staff's knowledge of evidence-based invasive mechanical ventilation was obviously enhanced, and their compliance of eight evidences was significantly improved (P<0.01), and the incidence of ventilator-associated pneumonia in critically ill children showed a downward trend. Conclusion: The application of evidence-based nursing program of invasive mechanical ventilation in critically ill children can standardize the evidence-based nursing behaviors, improve the evidence-based compliance of nurses, and reduce the incidence of ventilator-associated pneumonia.

Key words: critical care; children; mechanical ventilation; evidence-based practice; i-PARIHS framework