《儿童静脉输液治疗临床实践指南》更新版指南选题优先性评价的研究OA

Background Since its release in 2021,the Clinical Practice Guideline for Pediatric Intravenous Infusion Therapy(hereinafter referred to as the Pediatric Infusion Guideline)has been widely disseminated in the pediatric field.However,challenges persist in its clinical application.This update aims to provide more targeted recommendations for clinical nursing practices.Objective To clarify and refine the clinical questions identified by the guideline steering group for the pediatric intravenous infusion clinical practice guideline.Design A modified Delphi method.Methods The core secretariat conducted a literature review of intravenous therapy guidelines and expert consensus documents from the past five years,both domestically and internationally.Combined with clinical issues from the 2021 Pediatric Infusion Guideline,they preliminarily established the framework for the updated guideline's clinical questions.The UpPriority tool was used as the basis for evaluating the importance of clinical questions.A pre-survey was conducted by the unit secretariat to refine the Delphi questionnaire,which comprised two sections:expert consensus and literature-based systematic evaluation.The expert consensus included 4 items,while the literature-based systematic evaluation encompassed 5 dimensions,25 sub-dimensions,and 38 clinical questions.Participants included nursing managers and intravenous therapy team members from pediatric hospitals and maternal and child health hospitals across China.Main Outcome Measures Importance scores of clinical questions.Results A total of 44 participants from 18 pediatric hospitals and maternal and child health hospitals nationwide participated in the Delphi rounds.Only one clinical question failed to meet inclusion criteria."Dimension 5:Issues related to complications of various catheters in pediatric intravenous infusion"ranked highest in importance scores."Aseptic technique during catheter insertion"and"selection of intravenous infusion devices"were among the top-ranked clinical questions.No statistically significant difference was observed between nursing managers and intravenous therapy team members in their importance ratings(P>0.05).Kruskal-Wallis test revealed significant differences in importance scores across dimensions(χ²=181.93,P<0.001).The importance score of Dimension 2-5 is lower than that of multiple dimensions(Dimension 1,Dimension 2-1,Dimension 2-4,Dimension 3,Dimension 4 and Dimension 5)(P<0.05).The importance score of Dimension 5 is higher than that of multiple dimensions(Dimensions 2-2 to 2-5,Dimension 3-1,Dimension 3-4,and Dimensions 4-2 to 4-3)(P<0.05).Conclusion This Delphi study clarified the prioritization of clinical questions for the guideline update,providing more precise,outcome-oriented guidance for nursing practitioners.