卒中患者肠内营养临床护理实践与管理的现况调查
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女,硕士,护师

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中国医学科学院临床与转化医学研究专项项目(2021-I2M-C&T-A-023)


Nursing practice and management of enteral nutrition in stroke patients
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    摘要:

    目的 调查卒中患者肠内营养临床护理实践与管理现况,为推动证据临床转化提供依据。 方法 基于《中国卒中肠内营养护理指南》自行设计调查问卷,以便利抽样法抽取全国23所三甲医院卒中单元的护士961人进行调查。 结果 10所(43.5%)医院建立了卒中肠内营养管理的多学科团队,仅22.0%护士表示科室有卒中肠内营养支持相关标准规范或制度。近88.0%护士表示会进行营养风险和吞咽障碍的筛查,且主要实施者为护士,但筛查工具与证据推荐有差异。50.6%护士表示会在营养液输注时进行加温处理,且主要采用输液管加温器进行局部加热。同时,74.4%护士仍会常规检测胃残余量,主要采用注射器抽吸进行监测(97.8%)。 结论 卒中患者肠内营养临床护理实践及管理与证据推荐存在差异,管理者应重点关注存在差异的环节,进一步分析其阻碍因素与促进因素,并制定针对性干预措施,以促进卒中患者肠内营养临床护理实践的规范化。

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    Objective To investigate the current status of nursing practice and management of enteral nutrition in stroke patients, and to provide reference for promoting translation of evidence into the clinical practice. Methods A questionnaire was designed based on the "Chinese Stroke Enteral Nutrition Nursing Guide", then a convenient sample of 961 clinical nurses working in stroke units from 23 tertiary hospitals in China was surveyed. Results Ten (43.5%) hospitals established multidisciplinary teams for stroke enteral nutrition management, and only 22.0 percent of nurses reported that the department had relevant standards or regulations for stroke enteral nutrition support.Nearly 88.0 percent of nurses reported that the department provided screening for nutritional risk and dysphagia in stroke patients and nurses acted as the main implementer, but even so the screening tools used in nursing practice were not consistent with evidence recommendations.More than half of nurses convinced that they warmed the nutrient solutions in nutrition support by mainly using the intravenous infusion fluid tube warmer for local heating (50.6%).Almost 75 percent of nurses routinely measured residual gastric volume (74.4%), with predominant use of syringe aspiration technique (97.8%). Conclusion There are evidence-to-practice gaps in enteral nutrition for stroke patients.Recommendations for closing the gap include:greater attention of managers to this issue, further identification of barriers and facilitators, and redesign of targeted interventions.

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喻婷,韩慧,王聪,刘珊珊,蒋艳.卒中患者肠内营养临床护理实践与管理的现况调查[J].护理学杂志,2023,28(9):103-107

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  • 收稿日期:2022-12-27
  • 最后修改日期:2023-02-11
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  • 在线发布日期: 2023-12-29