基于理论域框架的护士临床应用指南规范实施肠内营养的障碍因素分析

doi:10.16460/j.issn1008-9969.2023.20.063

摘要/Abstract

摘要： 目的探讨护士临床应用指南实施肠内营养过程中的障碍因素。方法于2023年3-6月,运用理论域框架制订访谈提纲,便利选取荆州市中心医院肝胆外科一病区病房在岗的15名护士进行半结构式访谈,运用Colaizzi 7步分析法对访谈资料进行分析。结果本研究找出了与理论域框架4个领域有关的障碍因素,分别为“知识、社会/职业角色及认同、环境因素及资源、行为规范”。结论分析障碍因素得出3个结论：提高护士临床应用指南规范实施肠内营养需要强化知识与技能储备、积极拓展有利资源,激发工作效能,营造循证氛围、将证据与临床整合,制定集束化策略指导临床工作。影响护士临床应用指南实施肠内营养障碍是多方面的,应强化证据实施者的知识与技能,构建多学科团队,激发人员、物质的最大效能推动临床变革,依据指南制定本土化的变革措施。

关键词: 肠内营养, 理论域框架, 半结构访谈, 障碍因素

Abstract: Objective To explore the obstacles in the implementation of enteral nutrition based on clinical application guidelines in nurses. Methods From March to June 2023, 15 nurses in the Department of Hepatobiliary Surgery I, Jingzhou Central Hospital were selected for a semi-structured interview, the outline of which was developed based on Theoretical Domains Framework (TDF). The interview data was processed using the Colaizzi 7-step analysis method. Results This study identified obstacles related to 4 areas of TDF, including knowledge/social or professional role and identity, environmental factors and resource and behavioral norms. Conclusion Adequate knowledge and skill reserve, more favorable resources, higher work efficiency, evidence-based atmosphere, integration of evidence with clinical practice, and cluster strategy are all conducive to standardizing the implementation of enteral nutrition based on clinical application guidelines. There are multiple barriers to the implementation of enteral nutrition based on clinical application guidelines in nurses. Adequate knowledge and skills of the evidence implementers, and multidisciplinary teams should be considered to maximize the effectiveness of the personnel and materials, so as to promote clinical reform, and formulate localized measures according to the guidelines.

Key words: enteral nutrition, Theoretical Domains Framework, semi-structured interviews, obstacles

中图分类号:

R473.6

张乔, 刘昌丹, 鲁小小, 周娟, 丁娟. 基于理论域框架的护士临床应用指南规范实施肠内营养的障碍因素分析[J]. 护理学报, 2023, 30(20): 63-67.

ZHANG Qiao, LIU Chang-dan, LU Xiao-xiao, ZHOU Juan, Ding Juan. Barriers to implementation of enteral nutrition based on clinical application guidelines: a theoretical domains framework perspective[J]. Journal of Nursing, 2023, 30(20): 63-67.

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