Evidence-based Practice Of Time-limit Management In Transfusion Nursing Based On Iowa Model

Objective1.Relevant evidence of time-limit management of blood transfusion nursing at home and abroad was retrieved and evaluated,and summarized and integrated to form the best evidence of time-limit management of blood transfusion nursing,and to provide evidence-based evidence for clinical implementation of time-limit management of blood transfusion nursing.2.Based on the best evidence of time-limit management in blood transfusion nursing,review indicators were developed,barriers and promoting factors in evidence-based nursing practice were analyzed,and action strategies were formulated.Translate evidence in clinical trials to promote best clinical practice and benefit patients.Methods1.Using the Iowa model of evidence-based practice as the theoretical framework,this study systematically searched the guidelines,expert consensus,norms and standards related to time-limit management of blood transfusion nursing,and two researchers conducted independent screening,quality evaluation and information extraction of the literature.Summarize the best evidence for time-limited management of transfusion care.2.By holding expert discussion meetings,According to JBI Australia’s(Joanna Briggs Institute’s FAME(Feasibility,Appropriateness,Meaningfulness,Effectiveness Evaluation table has been used to evaluate the best evidence on time-limit management of transfusion nursing from four aspects:feasibility,appropriateness,clinical significance and effectiveness,and corresponding review indicators and review methods have been established.Nurses and transfusion patients in the clinical pilot ward from May 1,2022 to May 31,2022 were selected as the study objects.Participative observation and questionnaire survey were used to conduct baseline review.3.From June 1 to 15,2022,focus group interview was used to interview nurses in pilot wards about the obstacle factors of clinical application of best evidence.4.Based on the results of baseline review and qualitative research,obstacle factors and promoting factors in evidence-based nursing practice were analyzed,and action strategies were formulated.5.Implementation of evidence application strategies in pilot wards from June 16 to August 31,2022.From September 1 to 30,2022,nurses and blood transfusion case in the clinical pilot ward will be reviewed after the application of evidence.A before and after control study was used to compare the baseline review data with the post-evidence review data,and to analyze and evaluate the feasibility and effectiveness of applying the best evidence for time-limit management of transfusion nursing in the clinical pilot ward.Results1.A total of 6 literatures were included in this study,including 1 Chinese guide and 5 English guides.AGREE II evaluation results in 2 guidelines for Grade A and 4 guidelines for Grade B.The analysis was integrated into 4 recommended topics,with a total of 32 pieces of evidence.2.Analyze 32 pieces of evidence one by one by holding expert discussion meeting,form 28 review indicators,and determine the corresponding review objects and methods.By reviewing the baseline review data of indicators in clinical pilot departments,combined with the analysis of focus group interviews,it was concluded that the obstacle factors of this evidence-based project mainly included imperfect blood transfusion process,inadequate personnel training,incomplete blood transfusion information system,and inadequate quality control of blood transfusion time limit management.3.Before and after the application of clinical pilot evidence,there was no statistical difference in the knowledge rate of time-limit management of transfusion nursing among nurses,except for the improvement of indicators 7,8 and 16.The awareness rates of other 25 examination indicators were statistically significant.Comparison of the implementation of the time-limit management review indicators of blood transfusion care before and after evidence application showed that there was no data comparison for the review indicators 11,13,14,15,25 and 28,while the implementation rate of the review indicators 9,12 and 17 were 100%before and after evidence application.The implementation rate of other review indicators before and after evidence application was statistically significant.ConclusionThis study takes the Iowa model of Evidence-Based practice as the theoretical framework,with knowledge(guidelines related to blood transfusion time limit management)and clinical problems(clinical data)as the trigger points.based on evidence summary and obstacle factor analysis,Based on the evidence to improve the blood transfusion process standards,nurses training and practice supervision,promote the information construction of blood transfusion management,establish a normal blood transfusion time management quality control mechanism and other action strategies,carried out in the pilot ward evidence transformation practice research,achieved good results,worthy of clinical reference.