护士主导的高危科室吞咽障碍患者筛查及分级干预效果评价  

The effectiveness of screening and grading intervention for dysphagia in high-risk departments in all hospital led by nurses

作　　者：黄师菊[1] 蔡有弟[2] 李晓玲[1] 钟美浓 於雪英 刘玉霞[4] 刘萍[5] 陈妙霞[6] HUANG Shiju;CAI Youdi;LI Xiaoling;ZHONG Meinong;YU Xueying;LIU Yuxia;LIU Ping;CHEN Miaoxia(Surgical Department,The Third Affiliated Hospital Of Sun Yat-Sen University,Guangzhou,510630,China)

机构地区：[1]中山大学附属第三医院外科,广州市510630 [2]中山大学附属第三医院口眼病区,广州市510630 [3]中山大学附属第三医院呼吸内科,广州市510630 [4]中山大学附属第三医院神经外科,广州市510630 [5]中山大学附属第三医院神经内科,广州市510630 [6]中山大学附属第三医院护理部,广州市510630

出　　处：《中华护理杂志》2018年第11期1303-1308,共6页Chinese Journal of Nursing

基　　金：中国医师协会医院科研建设项目

摘　　要：目的探讨护士主导的高危科室吞咽障碍患者筛查及分级干预的效果。方法组建吞咽护理项目小组,制订筛查与分级干预方案,遴选高危科室和高危病种,制订工作指引、流程和质量控制方案,开展护士培训,于2017年3月开始实施筛查与干预工作并做好持续质量改进。结果全院13个吞咽障碍高危科室共筛查808例患者,吞咽障碍有112例,阳性率为13.86%。实施分级干预后,护士吞咽筛查率及措施落实率均为100%,专科护士会诊率达90.18%,医师会诊率达49.11%;并发症中营养不良的发生率下降,且差异有统计学意义(P<0.05);护士吞咽相关知识与护理技能水平均得到提高,且有统计学意义(P<0.05)。结论护士主导的吞咽障碍筛查及分级干预能早期识别吞咽障碍高危患者,提供个体化的评估与治疗方案,可有效改善患者的临床结局,提高护士专业能力和促进专科护理发展。Objective To explore the effectiveness of the nurse-led screening and grading intervention for dys- phagia in high-risk departments of all hospital. Methods A nursing team for swallow was set up,responsible for formulating a screening and grading intervention system. High-risk departments and diseases were screened and selected. Working instructions and quality control program were developed. Nurses were trained,and quality im- provement was carried out continuously,and implemented in March 2017. Results Totally 808 patients were screened in 13 high-risk departments for dysphagia,and 112 patients with dysphagia,the positive rate was 13.86%. After the grading intervention,the rate of swallowing screening and implementation were 100%,consuhation rate was 90.18% for specialist nurses and 49.11% for physicians. The incidence of complications such as malnutrition decreased. The knowledge and nursing skills of pneumonia among nurses were significantly improved （P〈0.05）. Conclusion The nurse-led screening and grading intervention for dysphagia can identify patients with high risk of dysphagia at an early stage. It can provide individualized evaluation and treatment plan for patients,which effectively improve the clinical outcomes of patients,improves professional ability of nurses and promotes the development of specialist nursing.

关 键 词：护士 吞咽障碍 筛查 干预性研究 

分 类 号：R47[医药卫生—护理学]