Evidence-based Practice Of Cardiac Rehabilitation Health Education For Patients After PCI

Objective:To search,evaluate and summarize the best evidence of cardiac rehabilitation health education for patients after PCI at home and abroad;to formulate "evidence-based practice program of cardiac rehabilitation health education for patients after PCI";to apply the program and evaluate its effect.Method:According to the JBI evidence-based health care model(updated version),the relevant literature on cardiac rehabilitation health education for patients after PCI was systematically searched and its quality was evaluated,the best evidence of cardiac rehabilitation health education for patients after PCI was screened and integrated,and the evidence-based practice program of cardiac rehabilitation health education for patients after PCI was established.According to the clinical evidence practice system of JBI evidence-based health care center,evidence-based practice was carried out in the coronary heart disease ward of a Grade 3A Hospital in Nanchang City,Jiangxi Province,including baseline review before evidence application,reform and re-review after evidence application.To compare the attitude and behavior level of 15 nurses in the pilot ward towards cardiac rehabilitation health education,the level of nurses’ knowledge,belief and practice of evidence-based nursing practice,the implementation rate of nurses to the examination index,the biological indexes of patients(30 cases before and after evidence application)and the level of self-management ability of patients before and after the application of evidence.Result:(1)A total of 13 articles were included,including 5 guidelines,3 clinical decisions,3 expert consensus,1 evidence summary and 1 systematic review,and finally formed the best evidence summary of cardiac rehabilitation health education for patients after PCI,including 45 pieces of evidence were summarized from 7aspects: recommendation and education,medication,exercise,nutrition,psychology,smoking cessation and risk factors management.(2)Through the expert group meeting,according to the FAME structure of JBI evidence,we screened and integrated the best evidence,and finally formulated the "evidence-based practice Program of Cardiac Rehabilitation Health Education for patients after PCI" and 37 review indicators.(3)According to the results of the baseline review before the application of the program,the obstacle factors in evidence-based practice include organizational level(lack of health education programs and materials),nurse level(low attitude and behavior score of cardiac rehabilitation health education,low knowledge,belief and practice score of evidence-based nursing practice and low implementation rate of review indicators),and patient level(lack of understanding of cardiac rehabilitation and self-management).(4)After the application of the program,patients’ distance of 6-minute walking test and left ventricular ejection fraction increased,while systolic blood pressure,total cholesterol and low density lipoprotein cholesterol decreased,and the difference was statistically significant(P<0.05).The scores of patients’ self-management ability,nurses’ attitude and behavior towards cardiac rehabilitation health education and nurses’ knowledge,belief and practice of evidence-based nursing practice increased from 64.77±9.75,89.67±5.25 and 104.60±7.81 to 75.77±9.46,100.47±6.60 and126.27±6.51 respectively,and the differences were statistically significant(P<0.001).Among the 37 review indicators,the composition ratio of items with implementation rate≥50% increased from 29.73% before the application of the program to 100%,and the difference was statistically significant(P<0.05).Conclusion:(1)This study summarized the best evidence of 45 pieces of cardiac rehabilitation health education for patients after PCI,recommended nurses to lead cardiac rehabilitation health education,and teach patients and caregivers from seven aspects of recommendation and education,medicine,exercise,nutrition,psychology,smoking cessation and risk factor management to make patients master self-management skills,and fully considered the feasibility,suitability,clinical significance and validity of the evidences,and formulated a localized "evidence-based practice Program of Cardiac Rehabilitation Health Education for patients after PCI".(2)After the application of "evidence-based practice Program of Cardiac Rehabilitation Health Education for patients after PCI",it can standardize nurses’ cardiac rehabilitation health education,improve nurses’ knowledge level of cardiac rehabilitation health education,expand nurses’ evidence-based thinking,improve patients’ self-management ability and improve patients’ prognosis.