| 袁媛,张冉,冯雅笛,李桂云.ICU护士肠内营养喂养护理实践规范性的评价及干预效果[J].上海护理,2019,19(9): |
| ICU护士肠内营养喂养护理实践规范性的评价及干预效果 |
| Evaluation of the standardization of ICU enteral nutrition feeding and the effect of intervention |
| DOI： |
| 中文关键词: ICU护士 肠内营养 护理操作 规范性 跨理论模型 干预 |
| 英文关键词:ICU nurses enteral nutrition feeding nursing operation normative transtheoretical model of change, Intervention |
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| 摘要点击次数: 1964 |
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| 中文摘要: |
| 目的 评价ICU护士肠内营养护理实践规范性，并探讨基于跨理论模型的培训对提高护士肠内营养护理操作实践规范性的效果。方法 采用便利抽样法，于 2018年1—7月选取首都医科大学附属北京天坛医院ICU的护士52名作为研究对象。通过文献回顾及专家咨询形成基于跨理论模型的肠内营养实践培训方案，分别在2018年1—3月、2018年5—7月通过现场观察及问答的形式确定护士肠内营养临床实践在跨理论模型中的分期情况，并于2018年4月采用该培训方案对52名护士进行为期1个月的干预。比较护士在培训前后在跨理论模型中的分期情况，采用自行设计的肠内营养喂养护理操作规范评价表评价ICU护士肠内营养护理操作的规范性。结果 ICU护士在执行肠内营养时，鼻饲管路基本情况、鼻饲液配置两部分各条目规范率均在95%以上。鼻饲前规范操作部分，规范性最差（规范率<50%）的4个方面为：肠内营养时抬高床头≥30o占20.1%，肠内营养前听诊喂养管位置占28.8%，肠内营养前给予翻身叩背占 38.5%，肠内营养前给予吸痰占40.4%。鼻饲后操作规范性最差（规范率<50%）的条目为：肠内营养喂养完毕检查肠内营养管位置及固定情况占44.2%。实施基于跨理论模型的培训后，两组研究对象的行为分期差异有统计学意义（P<0.05）；实验组在操作规范性最差5个方面的规范率均在80%以上，两组操作规范性有显著性差异（P<0.05）。结论ICU护士执行肠内营养时，在鼻饲管路基本情况、鼻饲液配置方面有较高的规范性。护士执行肠内营养时床头抬高角度≥30o，肠营营养前听诊喂养管位置，肠内营养前给予翻身、叩背、吸痰，肠内营养喂养完毕检查肠内营养管位置及固定情况等方面的规范性较差（规范率<50%）。针对以上问题，对ICU护士实施基于跨理论模型的培训，可以提高ICU护士执行肠内营养时护理操作的规范性（鼻饲前规范操作、鼻饲后规范操作）。 |
| 英文摘要: |
| objective to evaluate ICU nurses’ standardize tion of nursing practice of enteral nutrition feeding and explore the effect of cross-theoretical model on improving the standardization of enteral nutrition feeding. Methods the convenience sampling method was used to select the ICU of a third-level hospital as the investigation site from January to July 2018. From January to March 2018, the standardization of enteral nutrition feeding was observed when ICU nurses operate enteral nutrition support, which was regarded as the experimental group. From May to July, 2018, after the intervention by adopting cross-theoretical model, the standardization of enteral nutrition feeding was observed, which was regarded as the experimental group. Paired chi-square and rank sum tests were used for statistical analysis. Results the standard rate of feeding pipeline maintenance and nasogastric feeding liquid allocation in ICU nurses was above 95%. The worst five aspects were: 20.1% of patients raised their bed head at or greater than 30 points, 28.8% of patients raised by auscultation feeding tube, 38.5% of patients were turned over before intestinal feeding, 40.4% of patients were sucked before intestinal feeding, and 44.2% of patients were examined after intestinal feeding. After the intervention based on the transtheoretical model of change, behavioral stages between the two groups were statistically significant (P<0.05).The standard operating rate of the experimental group in the above 5 aspects was more than 80%, and there was significant difference in the operational normality between the two groups (P<0.05). Conclusion ICU nurses have high standardization in the basic condition of nasogastric feeding pipeline and nasogastric feeding liquid allocation when they perform enteral feeding. The standardization of the bed angle, auscultating the feeding tube position, turned over the body, knocked the back, and sputum before feeding, and cheking the position and fixation of the feeding tube after feeding have low standardization. The intervention based on transtheoretical model of change can improve the standardization of nursing operation when ICU nurses perform enteral feeding. |
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