Evidence-based analysis of stress hyperglycemia review indicators and disorder factors in neurosevere patients
基于循证的神经重症患者应激性高血糖审查指标及障碍因素分析

摘要

目的 开展神经重症患者应激性高血糖管理的循证实践，构建审查指标，分析循证实践过程中的障碍因素及促进因素，制订变革策略。方法 以澳大利亚JBI循证卫生保健模式为理论指导，确定循证护理问题，文献检索、评价及汇总证据，制定临床审查指标并明确审查方法，2023年8月1日-9月30日进行基线审查，根据基线审查结果分析循证实践过程中存在的障碍、促进因素进行分析，并制定相应的策略。结果 本研究共纳入15条最佳证据，制定15条质量审查指标，其中10条审查指标依从率＜60%。结论 该研究基于最佳证据和专业判断构建的审查指标科学、有效，具有适宜性和可行性，障碍因素及促进因素分析与变革策略的制订可为推进神经重症患者应激性高血糖管理临床实践提供保障。

Abstract

Objective To carry out the evidence-based practice of stress hyperglycemia management in neurosevere patients, construct review indicators, analyze the barriers and promoting factors in the process of evidence-based practice, and formulate strategies for change.
Methods Under the theoretical guidance of evidence-based health care model in Australian JBI, determine evidence-based care problems, literature search, evaluation and summarize evidence, develop clinical review indicators and clear review methods, conduct baseline review from August 1 to September 30,2023, analyze the obstacles and facilitating factors of evidence-based practice according to the baseline review results, and formulate corresponding strategies.
Results The study included 15 best evidence and developed 15 quality review indicators, of which 10 were <60% compliant.
Conclusion   The review indicators constructed based on the best evidence and professional judgment are scientific, effective, appropriate and feasible. The analysis of obstacle factors and facilitating factors and the formulation of change strategies can provide guarantee for promoting the clinical practice of stress hyperglycemia management in patients with neurosevere diseases.