关键词: 心房颤动；口服抗凝药物；循证护理

Abstract: Objective: Based on the Ottawa Model for Research Use, a long-term oral anticoagulation management protocol for patients with atrial fibrillation was constructed, aiming to ensure the safety of anticoagulant therapy. Methods: Evidence-based methods were used to search and synthesize evidence, and 24 audit criteria were formulated. From August 2022 to June 2023, nurses and patients with atrial fibrillation from the department of cardiology in a tertiary grade A hospital in Zhenjiang were selected by convenience sampling. A baseline audit was conducted to analyze barrier and facilitating factors, a protocol of "high-quality nursing upgrade + tripartite collaborative management" was constructed and implemented. The changes in evaluation indicators were compared before and after the implementation of the protocol. Results: After the implementation of the protocol, nurses' anticoagulation knowledge score increased from 63.85±9.12 to 88.27±6.34, and the compliance rate of 20 audit criteria improved, excluding 4 indicators with a 100.00% baseline review rate. Patients' medication adherence improved at 6 and 12 months after the implementation of the protocol. The incidence of falls decreased from 21.65% to 11.21%, and the incidence of bleeding decreased from 30.93% to 18.97%, with all differences statistically significant (P<0.05). There was no statistically significant difference in the incidence of stroke (P>0.05). Conclusion: The evidence-based practice can standardize the management process, enhance nurses' compliance with audit criteria and patients' medication adherence, reduce the risks of falls and bleeding, and ensure the safety of anticoagulant therapy.

Key words: atrial fibrillation; oral anticoagulation; evidence-based nursing