目的 开展结肠镜检查患者肠道准备时恶心呕吐预防与管理的循证实践，分析障碍及促进因素，制订行动策略，为临床实践提供依据。方法 系统检索国内外18个数据库和专业网站中肠道准备时恶心呕吐的预防与管理的相关文献，评价汇总证据，制订审查指标及审查方法。2023年8月对河北某三级甲等医院行结肠镜检查的患者肠道准备时恶心呕吐预防与管理循证实践进行审查，采用i-PARIHS模式分析障碍及促进因素，并制订行动策略。结果 基于10条最佳证据，制订13条审查指标，其中1条指标的执行率为100%、6条指标的执行率为0%。循证实践中的障碍因素包括未纳入最新证据、证据未被转化为可及可用形式等7项，促进因素包括循证实践可改善患者体验、与国家及医院政策契合等8项。据此制订行动策略，即优化护理常规、完善宣教内容等。结论 基于循证并结合专业人员判断制订的实践策略科学、适宜，具可操作性，可促进证据有效应用。

Objective To carry out evidence-based practice on the prevention and management of nausea and vomiting during bowel preparation in patients undergoing colonoscopy，analyze the obstacles and promoting factors，formulate action strategies，and provide a basis for clinical practice.Methods Relevant literature on the prevention and management of nausea and vomiting during bowel preparation were retrieved systematically from 18 domestic and foreign databases and professional websites.The evidence was evaluated and summarized.Review indicators and review methods were formulated.In August 2023，the evidence-based practice of prevention and management of nausea and vomiting during bowel preparation in patients undergoing colonoscopy in a tertiary A hospital in Hebei Province was reviewed.The i-PARIHS model was used to analyze the obstacles and promoting factors，and action strategies were formulated.Results Based on 10 best pieces of evidence，13 review indicators were formulated，among which the implementation rate of 1 indicator was 100% and that of 6 indicators was 0%.The obstructive factors in evidence-based practice included 7 aspects such as the latest evidence has not been included，evidence not being transformed into accessible and usable forms .The promoting factors included 8 aspects such as evidence-based practice could improve the patient experience and was in line with national and hospital policies.Based on this，action strategies were formulated，such as optimizing nursing routines and improving educational content，etc.Conclusions The review indicators formulated based on evidence and in combination with the judgment of professionals are scientific，appropriate and operational，which can promote the effective application of evidence.

R472.9

河北省政府资助临床医学优秀人才培养项目(ZF2023146)；复旦大学循证护理中心证据转化与临床应用项目(Fudanebn202319)