基于循證的燒傷癥狀管理

1、燒傷病人癥狀管理的循證實(shí)踐,,思考,護(hù)理實(shí)踐的終極目標(biāo)提高臨床護(hù)理質(zhì)量患者得到優(yōu)質(zhì)服務(wù),,,如何提高？,何謂優(yōu)質(zhì)？,,Get Research Into Practice,Background,In recent years, EBP has become a buzz-word or a catch phrase increasingly found in an array of publications and presenta

2、tions,What is already known,it is remarkable the concept has generated so much interest in different disciplines since 1990s,Background,What is already known,Journals are named for it, such as …,,,,Background,What is al

3、ready known,Books have been written about it…,,,Background,There are many national organizations or international cooperation networks, as well as multiple centers of EBP that promote and dedicate to evidence-based nursi

4、ng movementThe Agency for Healthcare Research and QualityThe Oncology Society (ONS)The National Institute for Clinical Excellence (NICE)Sigma Theta Tau International’s Research and Scholarship Advisory Committeethe

5、Joanna Briggs Institute and Collaborating Centers,What is already known,Background,What is already known,However, in spite of the enthusiasm for EBP in nursing over the last two decades, some authors have redefined EBP i

6、n ways that contradict, or at least add other factors to the original emphasis on empirical research foundationsNursing as a practice-based discipline, its knowledge patterns include empirics, aesthetics, the ethical,

7、and the personal,EBP is becoming a philosophical approach that is in opposition to rules of thumb and tradition,Jennifer S. Mesic. (2011). Understanding Research and Evidence-Based Practice. Journal of Infusion Nurs

8、ing, 34(3): 174-178,Background,At these above points, a critical analysis of EBP is a task for the nursing professionIn other handAlthough EBP has been described as a method to improve the quality of care or clinical p

9、ractice as well as the cost-effectiveness of patient careNurses today are struggling with how to access and implement EBP, for example in ChinaSo rethinking the essences and attributes of EBP is necessary to advance

10、 the knowledge translation in cancer nursing realm,What is already known,Mary E. Larkin, Chelby L. Cierpial, et al(2009). Research ambassadors: Bringing findings to the bedside . Nursing Management, 10:20-23,Background,

11、,關(guān)于循證實(shí)踐,關(guān)于循證實(shí)踐,,關(guān)于循證實(shí)踐,,關(guān)于循證實(shí)踐,是察覺臨床問題，將文獻(xiàn)中的證據(jù)與臨床實(shí)際中的問題結(jié)合在一起解決臨床問題的前提,關(guān)于循證實(shí)踐,,關(guān)于循證實(shí)踐,,關(guān)于循證實(shí)踐,循證實(shí)踐具體步聚,,,,2024/2/14,18,根據(jù)循證問題，界定檢索式首先檢索經(jīng)過循證評(píng)鑒的資源1.Cochrane library：OVID中的 All EBM review 2. 臨床證據(jù)(Clinical evidence)：BMA ht

12、tp://clinicalevidence.bmj.com英國(guó)醫(yī)學(xué)會(huì)發(fā)行，是全球最權(quán)威的循證醫(yī)學(xué)數(shù)據(jù)庫(kù)之一，3000種治療措施的證據(jù)，每月更新3. 最佳實(shí)踐（Best Practice）: http://bestpractice.bmj.com 英國(guó)醫(yī)學(xué)會(huì)（BMJ）和美國(guó)內(nèi)科醫(yī)師協(xié)會(huì)（ACP）發(fā)行，涵蓋基礎(chǔ)、預(yù)防、診斷、治療和隨訪等證據(jù),檢索循證資源,2024/2/14,19,4. 臨床實(shí)踐指南 美國(guó)國(guó)立指南庫(kù)（National G

13、uideline Clearinghouse, NGC）：http://www.guidelines.gov英國(guó)指南庫(kù)（Guidelines）：http://www.his.ox.ac.uk/guidelines/加拿大指南庫(kù): http://mdm.ca.cpgsnew/cpgs,檢索循證資源,2024/2/14,20,檢索經(jīng)過循證評(píng)鑒的資源（續(xù)）：JBI library（澳大利亞Joanna Briggs循證實(shí)踐中心）：ht

14、tp://www.joannabriggs.edu.auRNAO（加拿大安大略護(hù)理學(xué)會(huì)）臨床指南 www.rnao.orgNursing Consult （Elsevier）Campbell協(xié)作網(wǎng)：社會(huì)科學(xué)領(lǐng)域的證據(jù)、公共衛(wèi)生領(lǐng)域循證實(shí)踐期刊：Evidence Based Medicine ：http://ebm.bmj.comWorldviews on Evidence-based Nursing (1.944)Ev

15、idence Based Nursing 中國(guó)循證醫(yī)學(xué)雜志 （Cochrane 中國(guó)分中心主辦）,檢索循證資源,2024/2/14,21,查詢臨床實(shí)踐指南,美國(guó)衛(wèi)生保健研究和質(zhì)量管理局及美國(guó)醫(yī)學(xué)會(huì)主辦的《NGC》（美國(guó)臨床指南網(wǎng)站）(http://www.guideline.gov)可檢索到臨床實(shí)踐指南加拿大醫(yī)學(xué)會(huì)主辦的《CMA Infobase》（加拿大臨床指南網(wǎng)站）（http://mdm.ca.cpgsnew/cpgs/）上有指

16、南或指南章節(jié);澳大利亞JBI循證護(hù)理中心(http://www.joannabriggs. edu.au)發(fā)表了“最佳護(hù)理實(shí)踐報(bào)告”美國(guó)衛(wèi)生保健政策和研究署(AHCPR) 制訂的臨床實(shí)踐指南,2016 ISBI實(shí)踐指南：燒傷護(hù)理(Burn Care)燒傷康復(fù)治療指南（2013版）成人燒傷疼痛管理指南(2013版)2013 ESPEN支持建議：嚴(yán)重?zé)齻臓I(yíng)養(yǎng)治療燒傷感染的診斷標(biāo)準(zhǔn)與治療指南（2012版）,與燒傷相關(guān)指南：,查詢