脑卒中吞咽困难识别与管理循证实践方案的优化  

Optimization of the evidence-based practice protocol on post-stroke dysphagia identification and management

作　　者：赵俊强[1] 王晋芳[1] 郭海玲[2] 王芳[2] 李学靖[1] 马睛雅 郝玉芳[1] ZHAO Junqiang;WANG Jinfang;GUO Hailing;WANG Fang;LI Xuejing;MA Jingya;HAO Yufang(School of Nursing,Beijing University of Chinese Medicine / Joanna Briggs Institute Center of Excellence,Beijing University ofChinese Medicine / Best Practice Spotlight Organization,Registered Nurses＇ Association of Ontario,Beijing University of ChineseMedicine,Beijing 100029,China;Nursing Department,Dongzhimen Hospital,Beijing University of Chinese Medicine / Best Prac？tice Guidelines Implementation Center,Registered Nurses＇ Association of Ontario,Dongzhimen Hospital,Beijing 100700,China)

机构地区：[1]北京中医药大学护理学院、北京中医药大学JBI循证护理卓越合作中心(BUCM-JBC)、北京中医药大学加拿大安大略省注册护士协会最佳实践中心(BUCM-BPSO),北京市100029 [2]北京中医药大学东直门医院护理部、北京中医药大学东直门医院加拿大安大略省注册护士协会最佳实践指南应用中心,北京市100700

出　　处：《护理管理杂志》2018年第7期475-480,共6页Journal of Nursing Administration

基　　金：北京中医药大学2017年研究生自主课题项目(2017-JYB-XS-085)

摘　　要：目的对脑卒中吞咽困难识别与管理循证实践方案进行更新与优化,推动循证实践项目持续高效进行。方法采用文献研究法,检索国内外脑卒中吞咽困难相关的循证实践指南,结合利益相关者讨论更新临床实践的推荐条目,进而更新循证实践方案,通过专家会议法对方案进行修订和完善,形成终版脑卒中吞咽困难识别与管理循证实践方案。结果优化了脑卒中吞咽困难识别与管理实践方案,内容包括基于标准吞咽功能评估的吞咽困难筛查表和吞咽功能评估表,吞咽困难的分级管理方案,修订后的护士知识手册和患者健康教育手册等内容。结论研究对前期脑卒中吞咽困难识别与管理循证实践方案进行了更新和优化,以达到动态持续质量改进的目的。Objectives To optimize the evidence-based practice protocol on post-stroke dysphagia identification and management so as to promote the sustainability and effectiveness of the protocol.Methods Retrieve guidelines relevant to post-stroke dysphagia identification and management,renew the clinical practice items based on the guideline recommendations and stakeholder discussion,optimize the evidence-based practice protocol on post-stroke dysphagia identification and management afterwards,and come up with the final optimized version through expert consensus.Results The protocol has been optimized,including dysphagia screening tool based on Standardized Swallowing Assessment（ SSA）,graded dysphagia management protocol,revised nurse knowledge manual and patient health education manual.Conclusion It＇s necessary to update and optimize the evidence-based practice protocol when conducting evidence implementing project so as to improve the clinical nursing excellence continuously.

关 键 词：脑卒中 吞咽困难 循证护理 循证实践 循证实践方案 

分 类 号：R47[医药卫生—护理学] R473.74[医药卫生—临床医学]