摘要目的:了解国内6家医疗机构儿童重症监护病房（PICU）开展儿童中心静脉导管（CVC）维护与移除的循证护理实践的准备度现状，分析国内PICU的CVC维护及拔除证据应用面临的障碍，为制定变革策略提供依据。方法:本研究为横断面现况调查。采取便利抽样法，于2019年12月选取上海、广州、深圳、杭州、厦门及合肥的6家医疗机构PICU的169名护理人员进行调查。采用基本资料调查表和循证护理实践准备度评估（CREBNA）量表，通过问卷星发放问卷，评估临床护理人员对循证实践过程中证据、组织环境、促进因素3个方面的准备度情况。共发放问卷169份，回收有效问卷169份，有效回收率为100%。结果:6个证据应用场所共调查护理人员169名，多中心CREBNA量表总分为（136.96±15.33）分，占满分的88.36%。3个维度得分排序依次为组织环境维度（40.31±4.45）分、证据维度（53.43±6.14）分、促进因素维度（43.22±5.81）分。得分排序倒数5位的条目中有4个条目来自促进因素维度，4个场所得分较低的条目均属于促进因素维度。结论:PICU开展儿童CVC维护的最佳实践项目实施具备可行性，但各证据应用场所准备度仍有部分不足，尤其在促进因素方面应不断完善，进一步促进和维持变革实施。

abstractsObjective:To explore the status quo of the readiness of evidence-based nursing practice for the maintenance and removal of children's central venous catheter (CVC) in 6 domestic medical institutions Pediatric Intensive Care Unit (PICU), analyze the obstacles faced by the application of CVC maintenance and removal evidence in PICU, so as to provide basis for formulating reform strategies.Methods:This study was a cross-sectional survey. In December 2019, 169 nurses from PICU of 6 medical institutions in Shanghai, Guangzhou, Shenzhen, Hangzhou, Xiamen and Hefei were selected by convenience sampling for investigation. The General Information Questionnaire and Clinic Readiness to Evidence-based Nursing Assessment (CREBNA) were used to evaluate the readiness of clinical nurses to evidence, organizational environment and promoting factors in the process of evidence-based practice. A total of 169 questionnaires were issued, and 169 valid questionnaires were recovered, with a valid recovery rate of 100%.Results:A total of 169 nurses were investigated in 6 evidence application sites. The total score of the multi center CREBNA was (136.96±15.33), which was 88.36% of the full score. The scores of the three dimensions were as follows: organizational environment (40.31±4.45), evidence dimension (53.43±6.14), and promoting factors (43.22±5.81). Four of the last five items in the score ranking were from the promoting factor, and the low score items in four places were all from the promoting factor.Conclusions:The best practice project of children's CVC maintenance in PICU is feasible. However, there are still some deficiencies in the preparation of various evidence application sites, especially in the promoting factors, which should be constantly improved to further promote and maintain the implementation of change.