Objective: To investigate the cognition level of ICU nurses about evidence-based knowledge of ventilator-associated pneumonia (VAP) prevention and analyze the status of clinical evidence-based practice. Methods: A self-designed questionnaire was developed to assess the cognition of ICU nurses for prevention VAP. Two items of evidence-based practice were chosen for clinical evaluation. The researchers monitored the practice on random patients at random time every day. The compliance of practice was analyzed and then clinical practice were compared with nurses' knowledge. Results: The knowledge level of nurses about ventilator-associated pneumonia (VAP) prevention was acceptable. The correction rate for questionnaire items were higher than 70%, which maximum rate up to 100%. In clinical practice evaluation, the compliance rate of head-of-bed elevation and endotracheal tube cuff pressure on ventilated patients were 33.8% and 40%. There were no significant difference between ventilated patients and non-ventilated patients. Conclusion: The evidence-based knowledge is grasped well in ICU nurses, but the clinical practice need to be improved. The evidence-based practice should be put into practice through multifaceted methods, which is important for VAP prevention.%目的:调查重症监护室内护士对于预防呼吸机相关性肺炎(VAP)循证知识的掌握程度,并分析临床循证实践的现状,了解知识与行为之间的吻合度.方法:依据循证证据,自行设计调查问卷,对某“三甲”医院重症医学科护士进行预防VAP循证知识的调查.选取预防呼吸机循证指南中的“床头抬高”及“气管插管气囊内压”作为循证实践调查项目,由研究者每日随机抽取患者进行监测,分析其依从性,并与知识掌握率进行比较.结果:护理人员预防VAP循证知识掌握良好,各项目回答正确率均高于70.0％,最高可达100.0％.循证实践中机械通气患者床头抬高与气囊压执行达标率分别为33.8％与40.0％,而且与非机械通气患者之间差异无统计学意义.结论:护士对预防VAP循证知识掌握良好,但是临床循证实践不足,措施针对性不强,与循证标准差距显著.需要加强其由知识向行为的转化,提高循证实践的执行力度及依从性.
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