成人经鼻胃管喂养临床实践指南的构建  

Development of clinical practice guideline for nasogastric tube feeding in adult patients

作　　者：胡延秋 程云[1] 王银云[1] 夏文兰[1] 冯颖[2] 

机构地区：[1]复旦大学附属华东医院护理部,上海市200040 [2]复旦大学附属华东医院营养科,上海市200040

出　　处：《中华护理杂志》2016年第2期133-141,共9页Chinese Journal of Nursing

基　　金：复旦大学护理科研基金项目(FNF201301);上海市护理学会立项课题(2014SD-B04)

摘　　要：目的构建基于证据的成人经鼻胃管喂养的临床实践指南,为促进鼻饲护理实践,保证鼻饲安全提供参考。方法以JBI循证卫生保健模式为理论框架,严格按照循证临床实践指南制定的方法,构建《成人经鼻胃管喂养临床实践指南》草案,采用AGREE系统对指南草案进行专家评审,根据专家评审结果和建议对指南进行修改,形成正式指南。结果构建的指南推荐意见涵盖了鼻饲的适应证和禁忌证、胃管的选择及置管、确定胃管位置的方式、鼻饲喂养、营养配方、鼻饲给药、鼻饲相关并发症等内容,最终形成19个方面,99条推荐意见的指南草案。指南的AGREE评价得分较高,符合临床实践指南编写原则,也适用于我国成人鼻胃管喂养临床应用的现状,是一份实用性的指导意见。结论成人经鼻胃管喂养临床实践指南是根据我国临床实际、患者意愿和偏好、专业人员判断以及最佳证据而形成的循证指南,可为鼻饲临床护理实践提供参考,证据转化和临床应用是下一步研究的重点。Objective To develop evidence-based clinical practice guideline（CPG） for nasogastric tube feeding in adult patients,and to provide reference for clinical practice and promote patients＇ safety. Methods Guided by the theory of JBI evidence-based health care model and methodology of evidence-based nursing,a draft of guideline was developed. Then it was appraised according to AGREE （Appraisal of guidelines Research and Evaluation） Instrument. The CPG was finalized according to evaluation results and experts＇ advice. Results The recommendations of the CPG involved indications and contradictions of nasogastric tube feeding,selection and placement of nasogastrie tube,methods of verifying nasogastrie tube position,nasogastrie feeding regimen,nutrients for nasogastric feeding, medication administration and preventive measures of relevant complications,etc. The CPG contained 19 aspects and 99 items of recommendations. The scores according to AGREE Instrument were all above 80%. The CPG was suitable for domestic clinical settings and applicable to provide practical reference. Conclusion This practice guideline is constructed based on domestic clinical context,patients＇ wishes and preference,professional judgments and best evidence,providing valuable reference for nursing workers in clinical nursing practice. Emphasis of future research will be knowledge translation and evidence application.

关 键 词：鼻饲 循证护理学 指南 护理 

分 类 号：R472[医药卫生—护理学]