Development of blood glucose management review indicators and analysis of obstacles for diabetic nephropathy patients with hemodialysis based on i-PARIHS
10.3760/cma.j.cn115682-20250102-00026
- VernacularTitle:基于i-PARIHS的糖尿病肾病血液透析患者血糖管理审查指标制订及障碍因素分析
- Author:
Xiaoqiao QIU
1
;
Leyao ZHENG
;
Jin WANG
;
Xiangqin YIN
;
Zhilan HE
;
Xiaolan LUO
;
Lijuan DONG
Author Information
1. 广州中医药大学附属中山中医院肾病科，中山 528400
- Publication Type:Journal Article
- Keywords:
Diabetic nephropathies;
Hemodialysis;
Glycemic control;
Review indicator;
I-PARIHS
- From:
Chinese Journal of Modern Nursing
2025;31(32):4428-4436
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the application of blood glucose management evidence in hemodialysis patients with diabetic nephropathy within clinical practice, establish review indicators, and analyze both obstacles and enablers.Methods:Based on the feasibility, appropriateness, meaningfulness, and effectiveness (FAME) principle, the best evidence for blood glucose management in hemodialysis patients with diabetic nephropathy was evaluated. Ultimately, 21 pieces of evidence were included, and review indicators were established. A baseline review was conducted at the Hemodialysis Center of the Department of Nephrology, Zhongshan Hospital of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine, from August to September 2024. Based on the review findings, obstacles and enablers in the evidence-based practice process were analyzed, and change strategies were developed.Results:A total of 39 review indicators were established. Among these, one indicator achieved a 100.00% implementation rate, four indicators achieved an implementation rate between 80.00% and <100.00%, six indicators achieved an implementation rate between 60.00% and<80.00%, 19 indicators achieved an implementation rate between>0 and<60.00%, and nine indicators achieved a 0 implementation rate. After analyzing each review indicator, the primary obstacles included evidence not being transformed into clear and accessible formats, low awareness among healthcare providers and patients, lack of incentive mechanisms, significant gaps from existing nursing processes, insufficient manpower, need for external support, and requirement for additional training. Additionally, factors that promoted evidence translation included reliable sources of evidence, recognition and support for change from administrators and teams, a culture and experience of change within the team, the potential for change to yield significant benefits, and the availability of resources within the hospital to support the change.Conclusions:There is a significant gap between blood glucose management evidence and clinical practice among hemodialysis patients with diabetic nephropathy. Appropriate change strategies should be developed through clinical review and analysis of obstacles and enablers to promote the translation and application of evidence in clinical practice.
