Evidence-based practice for the volume management in the patients with chronic heart failure
10.3760/cma.j.cn211501-20200618-02826
- VernacularTitle:慢性心力衰竭患者出入量管理的循证实践
- Author:
Wei WANG
1
;
Xiaojing ZHAO
;
Xu ZHAO
;
Fang WANG
;
Aixia WANG
;
Lin JIN
Author Information
1. 山东第一医科大学附属省立医院心内科，济南 250021
- Keywords:
Chronic heart failure;
Output and input;
Volume;
Body mass;
Evidence-based practice
- From:
Chinese Journal of Practical Nursing
2021;37(24):1868-1874
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To apply the best evidence of evidence-based volume management in patients with chronic heart failure to clinical practice and evaluate its effect.Methods:From February 2018 to May 2019, according to the clinical evidence practice application mode of Joanna Briggs Institute (JBI), and the best evidence obtained in the previous study, we constructed audit indicators. And then perfomed clinical audits for the patients with chronic heart failure in the department of cardiology of Shandong Provincial Hospital affiliated to Shandong First Medical University. The obstacle factors were analyzed, and the action strategies were formulated. The cognition of the medical staff on the volume management, and the fasting body mass monitoring rate, the volume management target compliance rate, the time to dry body mass, average hospitalization day of the patients′, number of negative events related to volume management were compared before and after the application of the best evidence.Results:After the implementation of the reform, Indicator 8-14 and Indicator 20 of the 20 audit indicators implementation rate had been improved, and the difference was statistically significant ( χ 2 values were 6.668-97.000, P<0.05); the volume management target compliance rate increased from (34.24±30.33)% to (61.28±16.10)%, the difference was statistically significant ( t value was 30.21, P<0.001); the time to dry body mass decreased from (10.89±3.46) days to (5.48±1.58) days, the difference was statistically significant ( t value was 13.97, P<0.001); compared with the negative events related to the access control, the number of acute left heart failure cases decreased from 7 to 2 ( χ2 value was 4.194, P=0.041). Conclusion:Evidence-based volume management of patients with chronic heart failure can improve clinical nursing practice, shorten the time for patients to reach dry body mass, and reduce the average hospitalization day. Quality review still needs to continue to improve the quality of nursing.
