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中华重症医学电子杂志 ›› 2024, Vol. 10 ›› Issue (01) : 38 -41. doi: 10.3877/cma.j.issn.2096-1537.2024.01.006

临床研究

ICU患者肠内营养并发腹泻最佳证据的审查指标及障碍因素分析
黄瑞1, 王玉萍1, 孙倩1, 侯晓红2,()   
  1. 1. 250021 济南,山东第一医科大学附属省立医院东院重症医学科
    2. 250021 济南,山东第一医科大学附属省立医院东院肝胆外科
  • 收稿日期:2023-07-26 出版日期:2024-02-28
  • 通信作者: 侯晓红
  • 基金资助:
    山东省医药卫生科技发展计划项目(2019WS481)

Analysis of the best evidence of enteral nutrition complicated with diarrhea in ICU patients

Rui Huang1, Yuping Wang1, Qian Sun1, Xiaohong Hou2,()   

  1. 1. Department of Critical Care Medicine, East Hospital District of Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
    2. Department of Hepatological Surgery, East Hospital District of Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
  • Received:2023-07-26 Published:2024-02-28
  • Corresponding author: Xiaohong Hou
引用本文:

黄瑞, 王玉萍, 孙倩, 侯晓红. ICU患者肠内营养并发腹泻最佳证据的审查指标及障碍因素分析[J/OL]. 中华重症医学电子杂志, 2024, 10(01): 38-41.

Rui Huang, Yuping Wang, Qian Sun, Xiaohong Hou. Analysis of the best evidence of enteral nutrition complicated with diarrhea in ICU patients[J/OL]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2024, 10(01): 38-41.

目的

了解ICU患者肠内营养(EN)并发腹泻的最佳证据应用情况,分析障碍因素及促进因素,为证据的临床转化提供参考。

方法

依据乔安娜·布里格斯研究所(JBI)临床证据模式,获取ICU患者EN并发腹泻的最佳证据,制定审查指标及审查方法进行临床审查,根据审查结果进行障碍因素和促进因素分析,并制订行动策略。

结果

共纳入5篇指南,总结12条ICU患者EN并发腹泻的最佳证据,构建11条ICU患者EN并发腹泻的最佳证据的审查指标。其中1条审查指标执行率为100.0%,其余10条执行率为0~85.7%。主要障碍因素为科室无全面统一的EN并发腹泻评估、无腹泻评估工具、护士对腹泻管理的最佳证据了解不足、护士未重视对EN实施的交接、床旁手消毒液取用不方便等;主要促进因素为组织领导力强、护士学习能力强、医护合作氛围好等,并据此制订了行动策略。

结论

ICU患者EN并发腹泻最佳证据与临床应用存在差距,应针对障碍因素进行改进,促进证据的临床应用。

Objective

To understand the best evidence application of enteral nutrition (EN) combined with diarrhea in ICU patients, analyze obstacles and promoting factors, and provide reference for clinical conversion of evidence.

Methods

Based on the clinical evidence model of Joanna Briggs Institute (JBI), the best evidence of EN complicated with diarrhea in ICU patients was obtained. Review indicators and methods were developed for clinical review. Obstacle and promoting factors were analyzed based on the review results, and action strategies were developed.

Results

A total of 5 guidelines were included, 12 best evidence of EN complicated with diarrhea in ICU patients were summarized, and 11 review indicators of the best evidence of EN complicated with diarrhea in ICU patients were the best evidence of EN complicated with diarrhea in ICU patients constructed. The implementation rate of one review indicator was 100.0%, while the other 10 implementation rates were 0-85.7%. The main obstacle factors were the lack of a comprehensive and unified evaluation of EN complicated with diarrhea in the department, the lack of diarrhea evaluation tools, insufficient understanding of the best evidence for diarrhea management by nurses, lack of emphasis on the implementation of EN by nurses, and inconvenient access to bedside hand disinfectant. The main promoting factors were strong organizational leadership, strong learning ability of nurses, and a good atmosphere of medical and nursing cooperation, and based on this, action strategies were formulated.

Conclusion

There is a gap between the best evidence and clinical application of EN combined with diarrhea in ICU patients, and improvement should be made based on obstacle factors to promote the clinical application of the evidence.

表1 12条ICU患者EN并发腹泻的最佳证据
表2 11条ICU患者EN并发腹泻最佳证据的审查指标
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