ICU患者肠内营养支持并发腹泻的循证护理实践

发布时间：2018-07-15 09:54

【摘要】：目的探讨基于最佳证据的ICU患者肠内营养支持并发腹泻的干预方法并评价其效果。方法应用循证护理的方法得出证据并将证据本土化后应用于临床,制订ICU患者实施肠内营养支持并发腹泻的审查标准,规范护理人员的临床行为;采用线上线下的培训方式,对护理人员进行最佳证据的培训,比较应用最佳证据前后ICU患者肠内营养支持期间腹泻的发生率,培训前后护理人员对最佳证据的知晓情况及执行情况。结果最佳证据应用后,ICU患者肠内营养支持并发腹泻发生率由25.58%降至13.89%;ICU护士对腹泻识别与评估、肠内营养支持并发腹泻的相关因素分析、肠内营养配方选择、鼻饲给药等方面有所提高,差异有统计学意义(P0.05);应用前后在肠内营养输注方式、营养制剂保存方面的比较,差异无统计学意义(P0.05);ICU护理人员对肠内营养支持并发腹泻最佳证据的执行率大于80%。结论护理人员通过应用最佳证据,以科学的护理方法解决ICU患者肠内营养支持并发腹泻的问题,可提升护理质量。
[Abstract]:Objective to investigate the intervention of enteral nutrition in ICU patients with diarrhea based on the best evidence and evaluate its effect. Methods Evidence-based nursing was used to obtain evidence and apply it to clinical practice after localization of evidence. The examination standard of enteral nutrition for patients with diarrhea was established, the clinical behavior of nursing staff was standardized, and the training methods of line and offline were adopted. The best evidence training was conducted to compare the incidence of diarrhea during enteral nutrition support in ICU patients before and after the application of the best evidence, and the knowledge and implementation of the best evidence before and after training. Results after the best evidence was used, the incidence of enteral nutrition support complicated with diarrhea in ICU patients decreased from 25.58% to 13.89%. The factors related to enteral nutrition support complicated with diarrhea and the choice of enteral nutrition formula were analyzed. The difference was statistically significant (P0.05). There was no significant difference (P0.05) the implementation rate of the best evidence of enteral nutrition support complicated with diarrhea was higher than that of 80 nurses in ICU. Conclusion Nursing staff can improve the quality of nursing by applying the best evidence and using scientific nursing methods to solve the problem of enteral nutrition support complicated with diarrhea in ICU patients.
【作者单位】：华中科技大学同济医学院附属协和医院重症医学科;湖北省人民医院肿瘤科;华中科技大学同济医学院附属协和医院护理部;
【基金】：湖北省自然科学基金面上项目(2016CFB677)
【分类号】：R-03;R473

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