关键词: 胰岛素；注射轮换；循证实践；糖尿病；护理

Abstract: Objective: To explore the barriers to clinical application of evidence-based practice of insulin injection site selection and rotation. Methods: The semi-structured questions was made guided by the theoretical framework of PARIHS. Colaizzi was used for data analysis. Results: There are three themes namely evidence, organizational environment and facilitating factors. There are two sub-themes in evidence. (1) parts of the evidence were made without fully consideration of the clinical situation; (2) parts of the evidence were made without taking patients' will as consideration. There were five sub-themes under the theme of organizational environment. (1) health education materials were necessary; (2) doctors were not involved in this practice change while their supports were needed; (3) the head nurse needed to further clarify the specific role of leadership in evidence transformation; (4) the change would bring an increase in workload, but it was acceptable; (5) the rotation of insulin injection site was the biggest difficulty. There were two sub-themes under the theme of facilitating factors. (1) nurses agreed it was meaningful to implement the practice; (2) the standardized process system was a strong guarantee for the change implementation. Conclusion: Standard procedures, health education materials, rotation tools and patients' will need to be all taken into consideration to promote the application of the evidence-based practice of insulin injection site selection and rotation.

Key words: insulin; injection; rotation; evidence-based practice; diabetes; nursing