Application of the best evidence for standardized management of weakened population in elderly stroke patients
FU Xiuyun
FENG Caiyun
Abstract：Objective:To summarize the best evidence for standardized management of frail populations and explore the effectiveness of its application in elderly stroke populations.Methods:Systematically search for clinical practice guidelines,best practice standards,evidence summary,and expert consensus from the Cochrane Library,PubMed,EMbase,Web of Science,Joanna Briggs Institute(JBI)evidence-based healthcare center in Australia,CBM,CNKI,and WanFang Database.The retrievaltime was from the inception to March 1,2021.Finally,4 guidelines and 2 expert consensuses were obtained,and the included evidence was graded according to the GRADE grading system.Finally,7 pieces of evidence were included.Twelve review indicators were developed from five levels including the perspectives of evaluation,planning,exercise intervention,nutritional intervention,and psychological intervention.The elderly stroke patients hospitalized in the Neurology ward of the Affiliated Hospital of Qingdao University from March to September 2021 were selected as the research objects.100 patients'data were collected before the application of the best evidence,and 96 patients'data were collected after the application of the best evidence.Compared the implementation of the review indicators before and after the application of the best evidence,the degree of weakness of stroke patients,the degree of neurological impairment of patients,the ability of patients to take care of themselves,the level of knowledge,belief and practice of nurses in assessing and managing patients'weakness,and the ability of nurses to evidence-based practice.Results:After the application of evidence,the implementation rate of the 12 review indicators for standardized management of frailty among nurses increased significantly(P＜0.05);After the application of evidence,the modified Rankin Scale(mRS)score of patients was lower than before,and the modified Barthel Index(ADL)score was significantly improved compared to before,with a statistically significant difference(P＜0.05).The Frail Screening Scale(FRAIL)score showed no statistically significant difference before and after the application of evidence(P＞0.05),but the proportion of patients with frailty syndrome(≥ 3 points)was lower than before the application of evidence(P＜0.05).After the application of evidence,the scores and total scores of all dimensions of the knowledge,belief and practice level of nurses in the assessment and management of patients'weakness were improved,and the scores and total scores of all dimensions of nurses'evidence-based practice quality and implementation level were improved,with a statistically significant difference(P＜0.05).Conclusions:The application of the best evidence for the standardized management of the weak population has improved the nurses'knowledge,belief and practice level of the weak management and evidence-based practice ability,further standardized clinical behavior,thus improving the patients'neurological deficit symptoms and self-care ability,and improving the quality of clinical nursing,but it does not significantly improve the patients weak status in the short term.
Keywords：elderly strokeweaknessbest evidenceevidence-based nursingstandardized management
Publication Date：2023-12-31
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 4423-4428 )