经鼻胃管置入最佳循证实践方案的制定和应用  

Construction and application of the best evidence-based practice program for nasogastric tube insertion

作　　者：李岩 苏兰 冯丽[1] LI Yan;SU Lan;FENG Li(Department of Genneral Surgery,Drum Tower Hospital,School of Medicine,Nanjing University,Jiangsu,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院肝胆外科,210008

出　　处：《临床外科杂志》2021年第11期1040-1043,共4页Journal of Clinical Surgery

摘　　要：目的探讨基于最佳证据的经鼻胃管置入的临床实践并评价应用效果。方法遵循澳大利亚JBI证据临床应用模式,检索并总结病人术前经鼻胃管置入方法、判断胃管在位及减轻胃管置入不适感的最佳证据,制定审查指标,通过证据应用前对肝胆外科病区的29名医护人员和50例符合纳入标准的病人进行基线审查、实践变革和证据应用后再审查,判断实施效果。结果最佳证据应用后,改良了常规胃管置入操作流程,证据应用后医护人员对每条审查指标的知晓率提高,病人应用每条审查指标的执行率提高,病人不适减轻,胃管位置正确率提高,差异有统计学意义(P<0.05)。结论将病人术前鼻胃管置管的最佳证据总结并应用于临床实践,可提高医护人员留置胃管的操作水平,规范操作行为,减轻病人的不适,提高病人满意度。Objective To explore the clinical practice of best evidence-based practice program for nasogastric tube insertion and evaluate its application.Methods By referencing to Australia JBI model for evidence-based healthcare, we retrieved and summarized the best evidence for preoperative insertion of nasogastric tube, judged the position of nasogastric tube and alleviated the discomfort caused by the nasogastric tube insertion.Then we formed inspection indicators, maded baseline inspections before application of the best evidence on 29 medical staffs and 50 patients who met the inclusion criteria in department of hepatobiliary surgery, took transformative measures to boost application of the best evidence, and made post-application inspections to evlaute the effect.Results After the application of the best evidence, the routine operation process of gastric tube insertion was improved;the awareness rate of audit indicators in medical staffs, audit indicators implementation rate, and the correct rate of gastric tube implantation were significantly improved(P<0.05 for all).Conclusion The summarization and application of the best evidence for preoperative nasogastric tube insertion can improve medical staffs’ operation level of nasogastric tube insertion, standardize the operation behaviors, reduce the patients’ discomfort caused by the nasogastric tube insertion and improve their satisfaction.

关 键 词：胃管置入 胃肠减压 舒适 胃管位置 循证实践方案 

分 类 号：R472[医药卫生—护理学]