关键词: 重症监护病房, 循证护理学, 医用粘胶相关性皮肤损伤, 预防, 障碍因素分析

Abstract:

Objective To investigate the current clinical status of the prevention and management of medical adhesion-related skin injury in adult ICU patients，identify the obstacle factors in the process of best evidence transformation，and explore the coping strategies. Methods After systematically searching of relevant literature on this topic，the included literature and summarizing evidence were evaluated so as to establish review criteria and determine target values through consensus meetings. The baseline review was carried out，and the barrier analysis was explored based on the review results. Results A total of 29 evidences were selected for conversion，27 indicators were developed，and only 3 indicators achieved the target value. At the reform level，the main obstacles were the lack of relevant nursing system and process，the need to adjust original working procedures，and the impact on inherent way of thinking of nurses. The main barriers at the change recipient level were nurses’ resistance to increased workload，lack of knowledge and skills，and concern about medical burden of family members. The main obstacles at the organizational environment level included the lack of incentive，support and feedback mechanisms，and the field environment needs to be improved. Conclusion The analysis of obstacles to the process of evidence-based practice are helpful in identifying the resistance to change accurately，formulating improvement strategies centered on change，changing recipients and organizational environment，integrating the change into the work process and management system，and establishing effective incentive and feedback mechanisms to improve organizational environment. Ultimately，the best evidence will be translated into clinical practice.

Key words: Intensive Care Units, Evidence-Based Nursing, Medical Adhesive-Related Skin Injury, Prevention, Barrier factors analysis