Reducing unplanned discontinuation in continuous renal replacement therapy using the i-PARIHS framework
10.3969/j.issn.1671-332X.2025.11.012
- VernacularTitle:应用i-PARIHS模式降低连续肾脏替代治疗非计划下机率的研究
- Author:
Jiaxin ZHANG
1
;
Haiyan LIAO
1
;
Jialong FENG
1
;
Dongxia LIANG
1
Author Information
1. 广州医科大学附属番禺中心医院 广东 广州 511400
- Publication Type:Journal Article
- Keywords:
i-PARIHS framework;
CRRT patients;
Unplanned discontinuation rate;
Evidence-based practice study
- From:
Modern Hospital
2025;25(11):1683-1688
- CountryChina
- Language:Chinese
-
Abstract:
Objective This study aimed to apply the integrated Promoting Action on Research Implementation in Health Services(i-PARIHS)framework to translate best evidence into clinical practice,with the goal of reducing unplanned discontinua-tion of continuous renal replacement therapy(CRRT)and providing guidance for clinical staff.Methods A systematic search was conducted for guidelines,systematic reviews,evidence summaries,and expert consensus documents related to unplanned CRRT discontinuation.Retrieved literature underwent quality appraisal,synthesis,and integration.Through evidence-based group discussions,baseline clinical audits,and FAME(Feasibility,Appropriateness,Meaningfulness,Effectiveness)-based evi-dence appraisal,implementation strategies were developed across three i-PARIHS dimensions:context,recipients,and facilita-tion.Outcomes including unplanned CRRT discontinuation rates,average length of hospital stay,mortality,and nurse competen-cy were compared before and after evidence implementation.Results After evidence extraction,synthesis,and contextual adap-tation,a site-specific evidence translation model was established,comprising 16 audit criteria with corresponding review methods.Following implementation,significant reductions were observed in unplanned CRRT discontinuation rates,average length of stay,and mortality(all P＜0.05).Nurses' nursing competency also improved significantly(P＜0.05),indicating a positive impact of the evidence translation initiative.Conclusion The i-PARIHS framework effectively reduces unplanned CRRT discontinuation and is applicable in clinical practice.The results offer evidence for improving nursing quality and offering a reference for future evidence translation initiatives in critical care.
