基于循证的烧伤症状管理

烧伤病人症状管理的循证实践,思考,护理实践的终极目标提高临床护理质量患者得到优质服务,如何提高？,何谓优质？,Get Research Into Practice,Background,In recent years, EBP has become a buzz-word or a catch phrase increasingly found in an array of publications and presentations,What is already known,it is remarkable the concept has generated so much interest in different disciplines since 1990s,Background,What is already known,Journals are named for it, such as ,Background,What is already known,Books have been written about it,Background,There are many national organizations or international cooperation networks, as well as multiple centers of EBP that promote and dedicate to evidence-based nursing movementThe Agency for Healthcare Research and QualityThe Oncology Society (ONS)The National Institute for Clinical Excellence (NICE)Sigma Theta Tau Internationals Research and Scholarship Advisory Committeethe Joanna Briggs Institute and Collaborating Centers,What is already known,Background,What is already known,However, in spite of the enthusiasm for EBP in nursing over the last two decades, some authors have redefined EBP in ways that contradict, or at least add other factors to the original emphasis on empirical research foundationsNursing as a practice-based discipline, its knowledge patterns include empirics, aesthetics, the ethical, and the personal,EBP is becoming a philosophical approach that is in opposition torules of thumb and tradition,Jennifer S. Mesic. (2011). Understanding Research and Evidence-Based Practice. Journal of Infusion Nursing, 34(3): 174-178,Background,At these above points, a critical analysis of EBP is a task for the nursing professionIn other handAlthough EBP has been described as a method to improve the quality of care or clinical practice as well as the cost-effectiveness of patient careNurses today are struggling with how to access and implement EBP, for example in ChinaSo rethinking the essences and attributes of EBP is necessary to advance the knowledge translation in cancer nursing realm,What is already known,Mary E. Larkin, Chelby L. Cierpial, et al(2009). Research ambassadors: Bringing findings to the bedside . Nursing Management, 10:20-23,Background,关于循证实践,关于循证实践,关于循证实践,关于循证实践,是察觉临床问题，将文献中的证据与临床实际中的问题结合在一起解决临床问题的前提,关于循证实践,关于循证实践,关于循证实践,循证实践具体步聚,2017/11/8,18,根据循证问题，界定检索式首先检索经过循证评鉴的资源1.Cochrane library：OVID中的 All EBM review 2. 临床证据(Clinical evidence)：BMA 英国医学会发行，是全球最权威的循证医学数据库之一，3000种治疗措施的证据，每月更新3. 最佳实践（Best Practice）: 英国医学会（BMJ）和美国内科医师协会（ACP）发行，涵盖基础、预防、诊断、治疗和随访等证据,检索循证资源,2017/11/8,19,4. 临床实践指南 美国国立指南库（National Guideline Clearinghouse, NGC）：英国指南库（Guidelines）：http:/www.his.ox.ac.uk/guidelines/加拿大指南库: http:/mdm.ca.cpgsnew/cpgs,检索循证资源,2017/11/8,20,检索经过循证评鉴的资源（续）：JBI library（澳大利亚Joanna Briggs循证实践中心）：.auRNAO（加拿大安大略护理学会）临床指南 Nursing Consult （Elsevier）Campbell协作网：社会科学领域的证据、公共卫生领域循证实践期刊：Evidence Based Medicine ：Worldviews on Evidence-based Nursing (1.944)Evidence Based Nursing 中国循证医学杂志 （Cochrane 中国分中心主办）,检索循证资源,2017/11/8,21,查询临床实践指南,美国卫生保健研究和质量管理局及美国医学会主办的NGC（美国临床指南网站）()可检索到临床实践指南加拿大医学会主办的CMA Infobase（加拿大临床指南网站）（http:/mdm.ca.cpgsnew/cpgs/）上有指南或指南章节;澳大利亚JBI循证护理中心(http:/www.joannabriggs. edu.au)发表了“最佳护理实践报告”美国卫生保健政策和研究署(AHCPR) 制订的临床实践指南,2016 ISBI实践指南：烧伤护理(Burn Care)烧伤康复治疗指南（2013版）成人烧伤疼痛管理指南(2013版)2013 ESPEN支持建议：严重烧伤的营养治疗烧伤感染的诊断标准与治疗指南（2012版）,与烧伤相关指南：,查询临床实践指南,2017