临床护士验证盲插胃管在位方法的现况调研及影响因素分析  

The status and influencing factors of the methods used by nurses verifying the blinded inserted nasogastric tube placement

作　　者：崔飞飞 何丽琴 沈梅芬[2] 梅彬彬[2] 冯丽梅 王雯婷 陆晓燕[1] 

机构地区：[1]苏州大学附属第一医院重症医学科,215006 [2]苏州大学附属第一医院神经外科,215006 [3]江苏省苏州市中西医结合医院神经外科,215101

出　　处：《中国实用护理杂志》2017年第36期2846-2850,共5页Chinese Journal of Practical Nursing

摘　　要：目的了解临床护士验证成年人盲插胃管在位所采用的方法并分析其影响因素，探讨临床护士验证盲插胃管在位的最佳实践。方法根据美国危重护士协会（AACN）实践警报，自行设计调查问卷，对957名临床护士开展问卷调查。结果临床护士置胃管时以腹部听诊气过水声（70．53％，675／957）及抽吸物性状（68．97％，660/957）为主，X线摄影作为金标准认知及临床使用仍存在很大不足。所在科室、工作年限、是否是专科护士以及医院级别等影响X线使用（均P〈0．05）。年龄、学历、职称、医院级别、是否是专科护士、所在科室等影响X线摄影作为金标准的认知情况（均P〈0．05）。结论临床护士仍主要以传统的方法来验证盲插胃管是否在位，临床实践验证盲插胃管在位方法与AACN实践警报推荐仍有一定差距。X线摄影作为验证胃管在位的金标准，临床实施及认知情况受所在科室、是否是专科护士以及医院级别等诸多因素的影响。医院应通过建立知识共享平台，将验证胃管在位各种方法的利弊进行传播，加强不同人群对其认识。同时，有待基于影响因素进一步探究床边有效的验证胃管在位的方法，寻求验证盲插胃管在位方法的最佳实践。Objective To investigate the status and influencing factors of the methods used by nurses verifying the nasogastric tube placement blinded inserted in adult, and to explore the best practice of nursing staff to verify the nasogastric tube placement. Methods We designed the questionnaire and conducted survey to the clinical nursing staff in accordance with the American Association of Critical-Care Nurses practice alert. Results Air bolus auscultation （70.53% , 675/957） and aspirate appearance （68.97%, 660/957） were the most used method during insertion procedure. There was insufficient in the cognition of X-ray as the gold standard and the use in clinical.The department, work years, specialist nursesand hospitallevel impact X-ray use （all P 〈0.05）.Age, education,title,hospital level, specialist nurses and department impact the cognition of X-ray as the gold standard （all P 〈0.05）. Conclusions Nurses still use the traditional methods to verify the nasogastric tube placement. There is a certain gap between clinical practice and AACN practice alert in themethods used to verify nasogastric tube placement.As the gold standard to verify gastric tube placement, the use and cognition of X-ray are impacted by many factors, including the department, specialist nurses, hospital level, et al. Therefore, hospital should establish a knowledge sharing platform, which will help to spread the advantages and disadvantages of various methods used in verifying the nasogastric tube placement, and then to strengthen the cognition with different people. Furthermore, based on potential influencing factors, it is necessary to further explore new bedside effective method of verifying the nasogastric tube placement and seek the best practice to validate the method of blind intubation of nasogastric tube.

关 键 词：护士 鼻胃管 插管 

分 类 号：R47[医药卫生—护理学]