Abstract: Objective: To apply the best evidence for continuous quality improvement for nursing care in ICU continuous renal replacement therapy (CRRT) to clinical practice and evaluate its effectiveness, with the aim of providing a reference for improving CRRT nursing quality in clinical settings. Methods: An evidence-based team was established, guided by the Integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework. An evidence based practice plan was developed and implemented in the Department of Critical Care Medicine at a grade Ⅲ and first class hospital in Tianjin from May to July 2023. The comparison of the application of the best evidence before and after included the execution rates of review indicators, as well as differences in patient filter usage time, unplanned catheter removal rates, and the incidences of hypotension and hypothermia. Results: A total of 13 pieces of best evidence were incorporated, and 9 review indicators were established. After the application of the evidence, filter usage time increased. the unplanned weaning rate, hypotension, and hypothermia incidence all decreased, with statistically significant differences (P<0.05). Conclusion: Evidence-based practice for ICU CRRT nursing quality improvement can effectively improve CRRT treatment outcomes and reduce complication rates.

Key words: CRRT, Nursing quality, Evidence-based practice

摘要： 目的：将ICU连续性肾脏替代治疗（Continuous Renal Replacement Therapy，CRRT）持续护理质量改进的最佳证据应用于临床 实践中，评价其应用效果，为临床提高CRRT护理质量提供参考。方法：组建循证团队，以整合式健康服务领域研究成果应用的行动促进（integrated Promoting Action on Research Implementation in Health Services，i-PARIHS）框架为理论指导，制订循证实践方案，于2023年5月至7月，在天津市某三级甲等医院重症医学科开展循证实践，比较最佳证据应用前后审查指标执行率以及患者滤器使用时间、非计划性下机率、低血压及低体温发生率的差异。 结果：共纳入13条最佳证据，制定9条审查指标，证据应用后滤器使用时长较前有所增长；非计划性下机率、低血压及低体温发生率较前有所下降，差异有统计学意义（P＜0.05）。结论：ICU CRRT护理持续质量改进的循证实践，可有效提高CRRT治疗效果，降低并发症发生率。

关键词: 连续性肾脏替代治疗, 护理质量, 循证实践