胰岛素皮下注射操作的最佳证据总结

Summary of Best Evidence for the Operation of Subcutaneous Insulin Injections

摘要: 目的：检索、评价和整合胰岛素皮下注射操作的相关证据。方法：利用计算机系统全方位检索近年来发表的国际和国内关于胰岛素皮下注射的医学及护理专业领域的数据库，汇集出相关临床指南、系统评价、证据总结、专家共识、随机对照试验，推荐实践等，文献检索时限为建库至2023年3月30日，由2名研究者根据主题检索词分别进行严谨的文献质量评价和审核后，将证据根据与主题的相关度进行整合。结果：根据纳入标准，共筛选出12篇文献，包括临床决策1篇，系统评价2篇，临床指南2篇，证据总结6篇，专家共识1篇。通过证据总结，从操作前护士准备、操作前患者准备、操作中流程、操作后观察及护理4个方面共获得17条证据。结论：该研究归纳了近年来最新的注射技术成果，可为不同工作经验和不同学历的护士提供可靠的实践参考。在实际护理操作中，护理人员应具有批判思维，可结合本院制度、临床经验、临床情境、患者需求，具体问题具体分析，审慎地选择符合优质护理标准的最佳护理措施，并应用证据，从而提高患者安全注射的规范管理水平。

Abstract: Objective: To retrieve, evaluate, and integrate evidence related to the operation of subcuta-neous insulin injections. Methods: A comprehensive search of international and national databases on the medical and nursing specialties of subcutaneous insulin injection published in recent years was conducted using a computerized system to compile relevant clinical guidelines, systematic re-views, evidence summaries, expert consensus, randomized controlled trials, and recommended practices, etc. The literature was searched for the period from the establishment of the database to March 30, 2023. After quality evaluation and review, the evidence was integrated according to its relevance to the topic. Results: Based on the inclusion criteria, 12 papers were screened, including one clinical decision, two systematic reviews, two clinical guidelines, six evidence summaries, and one expert consensus. Through evidence summary, a total of 17 pieces of evidence were obtained from 4 aspects: preoperative nurse preparation, preoperative patient preparation, intraoperative procedure, and postoperative observation and care. Conclusion: This study summarized the latest results of injection techniques in recent years, which can provide a reliable practice reference for nurses with different work experience and different education levels. In actual nursing practice, nursing staff should be critical thinkers who can analyze specific problems and carefully select the best nursing measures that meet the standards of quality care, taking into account the hospital system, clinical experience, clinical situations, and patient needs, and apply the evidence to im-prove the standard management of safe patient injections.