Effect of evidence-based nursing on unplanned discontinuation of continuous renal replacement therapy in adult ICU patients
Continuous renal replacement therapy
Patients were randomly divided into a control group (conventional critical care) and an intervention group (evidence-based nursing) using a random number table method. The intervention group received an evidence-based nursing intervention; the steps were as follows. During the study period, continuous renal replacement therapy (CRRT) nursing coverage followed the unit’s staffing arrangement, and the intervention components were delivered to patients allocated to the intervention arm using standardized training, checklists, and quality-control procedures. Establishment of evidence-based research team: a total of 10 members, including two nursing managers (responsible for program design and quality control), three ICU nurse team leaders (working years ≥15 years, responsible for evidence summary and training), three ICU specialist nurses (working years ≥10 years, responsible for intervention implementation), and two nursing graduate students (responsible for data collection and statistics). Evidence-based search and evidence screening: Using the keywords “continuous renal replacement therapy/CRRT”, “unplanned interruption of CRRT”, and “guidelines/best practices”, we conducted an evidence-based search across major international and Chinese databases and guideline platforms (BMJ Best Practice, UpToDate, GIN, ISN, Cochrane Library, JBI database, PubMed, Embase, CNKI and Wanfang) from July 2019 to July 2024. Eligible evidence sources were appraised using AGREEII (for guidelines) and JBI tools (for other evidence types). Fifteen evidence sources were included: three guidelines, two expert consensus, eight evidence summaries, and two systematic reviews. Making an intervention plan and reviewing items: The team evaluated the evidence, and combined with the actual situation of ICU, the Delphi method was used to conduct two rounds of Delphi expert letter consultation. The evidence was summarized and sorted out according to expert opinions, and the feasibility, suitabilit
1. Age ≥18 years old 2. CRRT treatment duration ≥24 hours 3. Complete clinical data 4. Patients or their legal representatives voluntarily signed informed consent
1. Patients with abnormal coagulation function (prothrombin time >18 s or activated partial thromboplastin time >60 s) 2. Patients with severe mental disorders who cannot cooperate with treatment 3. CRRT-related complications (such as catheter infection) occurred before enrollment