摘要
目的通过设计ICU误吸查检单,以更好地警示和规范ICU医务人员在护理机械通气患者肠内营养支持期间的行为,从而降低机械通气患者肠内营养支持期间的误吸发生率。方法以循证护理学为理论基础,系统检索ICU机械通气患者误吸管理及预防的相关文献,结合ICU科室临床情境设计误吸查检单,将2020年1-6月纳入的患者作为对照组,2020年7-12月纳入的患者作为观察组,观察使用前后的效果。结果采用查检单后,护士在气囊压力合格率、床头抬高合格率、胃残余量监测执行率等方面高于对照组,差异具有统计学意义(P<0.05);观察组在声门下分泌物吸引的执行率高于对照组,促动剂的使用率、误吸的发生率等方面低于对照组,但差异无统计学意义(P>0.05)。结论使用ICU误吸查检单能有效规范ICU护理人员在气囊压力、床头抬高、胃残余量监测等操作的行为,并提高声门下分泌物吸引的依从性,降低ICU机械通气患者肠内营养支持期间误吸的发生率,进而提升护理质量,保障患者安全。
Objective To design a ICU aspiration checklist to warn and standardize the behavior of ICU medical staff during the period of enteral nutrition support for patients with mechanical ventilation,and to reduce the incidence of accidental aspiration in patients with mechanical ventilation during enteral nutrition.Methods Based on the theory of evidence-based nursing,literatures on the management and prevention of aspiration in ICU patients who receiving mechanical ventilation and tube feedings were searched systematically,and considering the ICU clinical situations,the aspiration checklist was designed and applied to clinical practice.Results After application of the checklist,the eligibility ratio of cuff pressure and elevate the head of bed,the compliance of monitoring gastric residual volume were higher than control group(P<0.05).The compliance of subglottic drainage in experimental group was higher than control group(P>0.05).In experimental group,the rate of using prokinetic agent and prevalence of aspiration were lower than control group(P>0.05).Conclusion This checklist can effectively standardize the behavior of ICU nurses practice in cuff pressure,elevate the head of bed,and gastric residual volume monitoring,it can increase the compliance of subglottic drainage and reduce the prevalence of aspiration during the period of enteral nutrition support in patients with mechanical ventilation,improve the quality of nursing and ensure patients'safety.
作者
米元元
明耀辉
朱丽群
李巧云
黄培培
李传圣
Mi Yuanyuan;Ming Yaohui;Zhu Liqun;Li Qiaoyun;Huang Peipei;Li Chuansheng(College of Public Health,Zhengzhou University,Zhengzhou Henan,450001;Department of Critical Care Medicine,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan Hubei,430022;Department of Nursing,Affiliated Hospital of Jiangsu University,Zhenjiang Jiangsu,212001;Department of Operation Room,Zhejiang Province People's Hospital,Hangzhou Zhejiang 310014;Department of Critical Care Medicine,Yantai Yuhuangding Hospital,Yantai Shandong,264000)
出处
《护士进修杂志》
2021年第11期988-993,共6页
Journal of Nurses Training
基金
江苏省镇江市民政政策理论研究课题(编号:2020ZJMZZD004)。
关键词
误吸
机械通气
肠内营养
营养支持
查检单
危重症护理
Aspiration
Mechanical ventilation
Enteral nutrition
Nutrition support
Checklist
Intesive care
