经鼻胃管喂养临床实践指南的临床应用

摘要

Objective To explore the effectiveness,feasibility and suitability of the guideline for nasogastric tube feeding in adult patients.Methods Based on the Ottawa Model of Research Use as framework,we screened relevant evidence from guidelines,and developed new nasogastric tube feeding nursing procedure.Nursing knowledge,the rate of compliance to new procedure and the incidence of complications of nasogastric tube feeding were used to evaluate the clinical effects of the guideline.Results Nurses' knowledge increased significantly(P＜0.05).Nurses had a high degree of implementation of the new procedure,with the rate of over 85％.Compared with the control group,the rate of complications of nasogastric tube feeing in the experimental group was lower than that in the control group.Especially,the rates of reflux and aspiration were significantly lower(P＜0.05).Both rates of tube shedding and skin damage in the intervention group were decreased significantly(P＜0.05).Conclusion The nasal feeding nursing guideline in our clinical scenarios has its effectiveness,feasibility and suitability.%目的 验证《经鼻胃管喂养临床实践指南》的有效性和可行性.方法 以渥太华证据转化模式为理论框架,从指南中筛选相关证据,构建新的鼻饲护理流程,在实施干预后,通过护士的鼻饲护理知识得分和对新流程的执行率及患者的鼻饲并发症发生情况等来评价指南应用效果.结果 护士鼻饲护理知识水平显著提高(P＜0.05);护士对鼻饲护理新流程的执行率达85.00％以上;与对照组相比,实验组的鼻饲并发症发生率降低,其中反流、误吸的发生率显著降低,差异具有统计学意义(P＜0.05);实验组的胃管移位和固定处皮肤受损发生率显著降低,差异具有统计学意义(P＜0.05).结论 《经鼻胃管喂养临床实践指南》在国内的临床情景下应用具有一定的有效性、可行性.