[1]郭文超,滕娇,刘嘉龙,等.成人重型颅脑损伤患者肠内营养支持证据应用审查及障碍因素分析[J].军事护理,2023,40(09):92-95103.[doi:10.3969/j.issn.2097-1826.2023.09.023]
　GUO Wenchao,TENG Jiao,LIU Jialong,et al.Enteral Nutrition Support Evidence in Adult Patients with Severe Head Injury:Application Review and Obstacle Factors Analysis[J].Nursing Journal Of Chinese People's Laberation Army,2023,40(09):92-95103.[doi:10.3969/j.issn.2097-1826.2023.09.023]
点击复制

成人重型颅脑损伤患者肠内营养支持证据应用审查及障碍因素分析
分享到：

《军事护理》[ISSN:2097-1826/CN:31-3186/R]

卷:
40
期数:
2023年09期
页码:
92-95103
栏目:
循证护理
出版日期:
2023-09-15

文章信息/Info

Title:
Enteral Nutrition Support Evidence in Adult Patients with Severe Head Injury:Application Review and Obstacle Factors Analysis
文章编号:
2097-1826(2023)09-0092-05
作者:
郭文超1; 2; 滕娇1; 2; 刘嘉龙1; 2; 孙建3; 王忠丽4; 秦寒枝2
(1.安徽中医药大学 护理学院,安徽 合肥230031; 2.中国科学技术大学附属第一医院 护理部,安徽 合肥 230001; 3.中国科学技术大学附属第一医院 急诊重症监护室; 4.中国科学技术大学附属第一医院 神经外科)
Author(s):
GUO Wenchao1; 2; TENG Jiao1; 2; LIU Jialong1; 2; SUN Jian3; WANG Zhongli4; QIN Hanzhi2
(1.College of Nursing,Anhui University of Chinese Medicine,Hefei 230031,Anhui Province,China; 2.Department of Nursing,The First Affiliated Hospital of University of Science and Technology of China,Hefei 230001,Anhui Province,China; 3.Emergency Intensive Care Unit,The First Affiliated Hospital of University of Science and Technology of China; 4.Department of Neurosurgery,The First Affiliated Hospital of University of Science and Technology of China)
关键词:
重型颅脑损伤;  肠内营养;  循证护理;  审查指标;  障碍因素
Keywords:
severe head injury;  enteral nutrition;  evidence-based nursing;  review indicator;  obstacle factor
分类号:
R473
DOI:
10.3969/j.issn.2097-1826.2023.09.023
文献标志码:
A
摘要:
目的 了解成人重型颅脑损伤患者肠内营养支持证据临床应用现状,分析循证护理实践中的障碍因素、促进因素,为证据的临床转化提供依据。方法 以基于证据的持续质量改进模式为理论指导,检索、评价及汇总最佳证据,制定审查指标,根据基线审查结果分析障碍及促进因素。结果 根据11条最佳证据制定18条审查指标,12条指标依从率<60%,其中6条指标依从率为0。障碍因素主要为缺乏规范化流程、医护人员相关知识欠缺、培训不足等。结论 本研究基于最佳证据制定的质量审查指标具有科学性、规范性及可操作性,可针对障碍因素及促进因素实施临床变革及管理改进,促进证据转化。
Abstract:
Objective To explore the clinical application status of evidence for enteral nutrition support in adult patients with severe head injury,and to analyze the obstacles and promoting factors in the implementation of evidence-based nursing,thus to provide basis for clinical transformation of evidence.Methods Under the theoretical guidance of the evidence-based continuous quality improvement model,the evidence was searched,evaluated and summarized.Review indicators were developed.Obstacles and promoting factors according to the results of the baseline review were analyzed.Results Totally 18 quality examination indexes were formulated according to the 11 best evidence.The compliance rate of 12 indicators was less than 60%.Among them,compliance rates of 6 indicators were 0.The main obstacle factors were lack of standardized process,relevant knowledge of medical staff,and training.Conclusions The quality examination index based on the best evidence in this study is scientific,standardized and practical,which can implement clinical reform and management improvement according to the obstacle factors and promoting factors,and promote the transformation of evidence.

参考文献/References:

[1] LI X,YANG Y,MA Z F,et al.Enteral combined with parenteral nutrition improves clinical outcomes in patients with traumatic brain injury[J].Nutr Neurosci,2022,25(3):530-536.
[2] GIACINO J T,WHYTE J,BAGIELLA E,et al.Placebo-controlled trial of amantadine for severe traumatic brain injury[J].N Engl J Med,2012,366(9):819-826.
[3] YANG L,LIAO D,HOU X,et al.Systematic review and meta-analysis of the effect of nutritional support on the clinical outcome of patients with traumatic brain injury[J].Ann Palliat Med,2021,10(11):11960-11969.
[4] REINTAM BLASER A,STARKOPF J,ALHAZZANI W,et al.Early enteral nutrition in critically ill patients:ESICM clinical practice guidelines[J].Intensive Care Med,2017,43(3):380-398.
[5] 郭文超,秦寒枝,滕娇,等.成人重型颅脑损伤患者肠内营养支持的最佳证据总结[J].中国全科医学,2022,25(15):1825-1832.
[6] 周英凤,胡雁,顾莺,等.基于证据的持续质量改进模式图的构建[J].中国循证医学杂志,2017,17(5):603-606.
[7] 朱政,胡雁,邢唯杰,等.不同类型循证问题的构成[J].护士进修杂志,2017,32(21):1991-1994.
[8] DICENSO A,BAYLEY L,HAYNES R B.Accessing pre-appraised evidence:fine-tuning the 5S model into a 6S model[J].Evid Based Nurs,2009,12(4):99-101.
[9] BROUWERS M C,KHO M E,BROWMAN G P,et al.AGREE Ⅱ:advancing guideline development,reporting and evaluation in health care[J].CMAJ,2010,182(18):E839-E842.
[10]胡雁,郝玉芳.循证护理学[M].2版.北京:人民卫生出版社,2018:77-94.
[11]周英凤,胡雁,顾莺,等.促进基于证据的最佳实践,持续改进临床质量[J].护理研究,2016,30(35):4432-4434.
[12]周英凤,朱政,胡雁,等.推动证据向临床转化(八)审查指标的构建[J].护士进修杂志,2020,35(14):1281-1284.
[13]周雪梅,钱红继,吴娟,等.经皮冠状动脉介入术后患者规范化饮水的审查指标及障碍因素分析[J].中华护理杂志,2021,56(7):1031-1037.
[14]顾梦倩,赵燕燕,陈圣枝,等.ICU病人医疗器械相关压力性损伤证据应用审查及障碍因素分析[J].护理研究,2020,34(13):2257-2263.

相似文献/References:

[1]杨玉霞,顾莺,胡静,等.儿科重症监护病房患儿肠内营养中断的研究进展[J].军事护理,2021,38(02):69.[doi:10.3969/j.issn.1008-9993.2021.02.018]
[2]王汇,程岚,唐淑慧,等.失效模式与效应分析在降低ICU患者肠内营养相关性腹泻中的应用[J].军事护理,2022,39(09):25.[doi:10.3969/j.issn.1008-9993.2022.09.007]
　WANG Hui,CHENG Lan,TANG Shuhui,et al.Application of Failure Mode and Effect Analysis in Reducing Enteral Nutrition-Related Diarrhea in ICU Patients[J].Nursing Journal Of Chinese People's Laberation Army,2022,39(09):25.[doi:10.3969/j.issn.1008-9993.2022.09.007]
[3]韩梦丹,张媛,侯萃,等.成人肠内营养患者鼻肠管堵管预防与处理最佳证据总结[J].军事护理,2023,40(04):88.[doi:10.3969/j.issn.2097-1826.2023.04.022]
　HAN Mengdan,ZHANG Yuan,HOU Cui,et al.Prevention and Management of Nasointestinal Tube Obstruction in Adult Patients with Enteral Nutrition:Best Evidence Summary[J].Nursing Journal Of Chinese People's Laberation Army,2023,40(09):88.[doi:10.3969/j.issn.2097-1826.2023.04.022]
[4]李营阳,候琳琳,蒋恩社,等.半固化喂养在危重患者肠内营养中的应用与护理[J].军事护理,2023,40(05):93.[doi:10.3969/j.issn.2097-1826.2023.05.023]
[5]李阳洋,俞荷花,彭飞,等.超声监测胃残余量在急性创伤性完全性颈脊髓损伤患者肠内营养中的应用研究[J].军事护理,2023,40(06):5.[doi:10.3969/j.issn.2097-1826.2023.06.002]
　LI Yangyang,YU Hehua,PENG Fei,et al.Application of Ultrasonic Monitoring of Gastric Residual Volume in Enteral Nutrition in Patients with Acute Traumatic Complete Cervical Spinal Cord Injury[J].Nursing Journal Of Chinese People's Laberation Army,2023,40(09):5.[doi:10.3969/j.issn.2097-1826.2023.06.002]

备注/Memo

备注/Memo:
【收稿日期】2022-11-18【修回日期】2023-08-02
【基金项目】国家临床重点专科建设项目(国卫办医函〔2018〕292号)
【作者简介】郭文超,硕士,电话:0551-62283296
【通信作者】秦寒枝,电话:0551-62283296
更新日期/Last Update: 2023-09-15