肿瘤病人静脉通路选择决策的证据审查

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Venous pathway selection decision in tumor patients：an evidence review

TANG Shuhui，QIAN Huohong，CAO Jie，CHEN Jiayun，ZHOU Ruzhen

First Affiliated Hospital of Naval Medical University，Shanghai 200433 China

Corresponding AuthorQIAN Huohong，E-mail：qianhh_1114@163.com

AbstractObjective：To develop a review index for the assessment and selection of intravenous access for oncology patients based on an evidence-based approach，and to conduct a clinical review. Barriers and facilitators were further analyzed to provide references for standardized management of clinical venous access selection. Methods：The best evidence was developed based on an evidence-based approach，and review indicators were developed and reviewed among 164 oncology patients and 168 healthcare professionals in our hospital. The i-PARIHS framework was used to analyze the barriers and facilitators and to develop appropriate responses. Results：A total of 26 pieces of best evidence were summarized and 16 review indicators were developed.Evidence was reviewed in 164 tumor patients，there were 7 indicators with adherence <60%; 62.20% of patients had decision-making conflicts，and 46.34% of patients had delayed decision-making status. Conclusion：Clinical training related to the assessment and selection of intravenous access should be increased，the selection process of intravenous access should be optimized，the elements of assessment and selection should be refined，and the quality control supervision of the selection process of intravenous access should be increased. We should optimize the patient follow-up system，build an information system for decision-making assistance，and promote the clinical translation of evidence.

Keywordstumor;vascular pathways;evaluation;evidence-based nursing;clinical practice;obstacle factors;promoting factors;evidence review

摘要目的：基于循证方法制定肿瘤病人静脉通路置管前评估与选择的审查指标，并进行临床审查，进一步分析障碍因素及促进因素，为规范管理临床静脉通路选择提供参考。（剩余8281字）