Audit indicators development and obstacle factors analysis for perioperative frailty management in elderly patients
10.3760/cma.j.cn211501-20241018-02859
- VernacularTitle:老年患者围手术期衰弱管理审查指标的构建及障碍因素分析
- Author:
Xinyi ZHONG
1
;
Xingxing LU
1
;
Jingyan YANG
1
;
Lifen XU
1
Author Information
1. 华中科技大学同济医学院附属协和医院泌尿外科，武汉 430030
- Publication Type:Journal Article
- Keywords:
Aged;
Perioperative period;
Frailty;
Evidence-based nursing;
Baseline review;
Obstacle factors
- From:
Chinese Journal of Practical Nursing
2025;41(29):2249-2256
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To conduct a baseline review of the best evidence for perioperative fraility management in elderly patients, construct review indicators, systematically analyze obstacle factors and promoting factors, and formulate corresponding change strategies, so as to provide reference for clinical transformation of evidence.Methods:With the Joanna Briggs Institute evidence-based health care model as the guiding framework, the best evidence of perioperative frailty-management in elderly patients was summarized, and the review indicators and review methods were formulated on the basis of the evidence. From April 2024 to May 2024, a baseline review of the hospital system of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, medical staff and patients were conducted to analyze the obstacles in clinical practice and formulate corresponding change strategies, guided by integrated-promoting action on research implementation in health services framework(i-PARIHS).Results:According to 19 best evidence, 20 review indicators were established, among which 10 review indicators compliance rate was less than 60% and higher than 0, 2 review indicators compliance rate was 0. Based on the results of the i-PARIHS evidence-based conceptual framework analysis, the obstacle factors included the evidence content was not specific and inaccessible; lack of knowledge and skills in healthcare; the workload of medical care increased; the patient was old and had weak receptivity, lack of systematic practice process; lack of multidisciplinary communication mechanisms.Conclusions:There is a big gap between the best evidence of perioperative frailties management in elderly patients and clinical practice. Clinical departments need to deeply analyze the obstacles to clinical practice based on the existing clinical environment and resource allocation, and formulate targeted strategies to promote the better integration of evidence into clinical practice.
