成人重型颅脑损伤患者肠内营养支持证据应用审查及障碍因素分析  

Enteral Nutrition Support Evidence in Adult Patients with Severe Head Injury:Application Review and Obstacle Factors Analysis

作　　者：郭文超 滕娇 刘嘉龙 孙建[3] 王忠丽 秦寒枝 GUO Wenchao;TENG Jiao;LIU Jialong;SUN Jian;WANG Zhongli;QIN Hanzhi(College of Nursing,Anhui University of Chinese Medicine,Hefei 230031,Anhui Province,China;Department of Nursing,The First Affiliated Hospital of University of Science and Technology of China,Hefei 230001,Anhui Province,China;Emergency Intensive Care Unit,The First Affiliated Hospital of University of Science and Technology of China;Department of Neurosurgery,The First Affiliated Hospital of University of Science and Technology of China)

机构地区：[1]安徽中医药大学护理学院,安徽合肥230031 [2]中国科学技术大学附属第一医院护理部,安徽合肥230001 [3]中国科学技术大学附属第一医院急诊重症监护室 [4]中国科学技术大学附属第一医院神经外科

出　　处：《军事护理》2023年第9期92-95,103,共5页MILITARY NURSING

基　　金：国家临床重点专科建设项目(国卫办医函[2018]292号)。

摘　　要：目的了解成人重型颅脑损伤患者肠内营养支持证据临床应用现状,分析循证护理实践中的障碍因素、促进因素,为证据的临床转化提供依据。方法以基于证据的持续质量改进模式为理论指导,检索、评价及汇总最佳证据,制定审查指标,根据基线审查结果分析障碍及促进因素。结果根据11条最佳证据制定18条审查指标,12条指标依从率<60%,其中6条指标依从率为0。障碍因素主要为缺乏规范化流程、医护人员相关知识欠缺、培训不足等。结论本研究基于最佳证据制定的质量审查指标具有科学性、规范性及可操作性,可针对障碍因素及促进因素实施临床变革及管理改进,促进证据转化。Objective To explore the clinical application status of evidence for enteral nutrition support in adult patients with severe head injury,and to analyze the obstacles and promoting factors in the implementation of evidence-based nursing,thus to provide basis for clinical transformation of evidence.Methods Under the theoretical guidance of the evidence-based continuous quality improvement model,the evidence was searched,evaluated and summarized.Review indicators were developed.Obstacles and promoting factors according to the results of the baseline review were analyzed.Results Totally 18 quality examination indexes were formulated according to the 11 best evidence.The compliance rate of 12 indicators was less than 60%.Among them,compliance rates of 6 indicators were 0.The main obstacle factors were lack of standardized process,relevant knowledge of medical staff,and training.Conclusions The quality examination index based on the best evidence in this study is scientific,standardized and practical,which can implement clinical reform and management improvement according to the obstacle factors and promoting factors,and promote the transformation of evidence.

关 键 词：重型颅脑损伤 肠内营养 循证护理 审查指标 障碍因素 

分 类 号：R473[医药卫生—护理学]