Establishment of Evidence-Based Nursing Indices for Dysphagia After Anterior Cervical Spine Surgery.

Abstract

Aim: To select and obtain relevant evidence for the management of dysphagia after anterior cervical spine surgery both domestically and internationally, clinical quality evaluation indicators were developed based on evidence-based nursing practices, and obstacles and promoting factors in evidence-based nursing practices were analysed. This research was aimed to provide a basis for evidence-based nursing practices to promote standardized management of dysphagia after anterior cervical surgery.

Background: Dysphagia is the most common complication following anterior cervical surgery, but there is a lack of standard protocols and guidelines to direct clinical practice.

Design: Mixed methods were employed for the translational research to support evidence-based practice.

Data sources: This study was based on the JBI evidence-based health care model. According to the '6S Evidence Resource Pyramid Model', we searched from top to bottom.

Methods: This study is guided by the knowledge to action (KTA) evidence-based practice model. Utilizing a comprehensive evidence-based approach and following the 6S evidence resource pyramid model, relevant evidence on the management of swallowing disorders after cervical anterior surgery was selected from both domestic and international sources. Based on the best available evidence, the Delphi expert consultation method was used to establish a management plan for swallowing disorders post-cervical anterior surgery. Semi-structured interviews were then conducted to identify barriers to clinical implementation, and clinical quality evaluation indicators, as well as promoting factors, were subsequently developed.

Results: Based on the 31 best evidence points, 12 evaluation indicators were developed. The baseline results of these indicators reveal that, apart from evaluation indicator 8, which has a compliance rate of 72.2%, the compliance rates for most of the other indicators are relatively low. Based on the results of the clinical quality review, the following main obstacles were analysed: negative behaviours and attributes, lack of professional knowledge, and lack of standardized management.

Conclusions: Effective management of swallowing disorders after cervical spine surgery is crucial for enhancing treatment outcomes, reducing complications, shortening hospital stays and improving patient quality of life. This study identified the best evidence for managing dysphagia post-anterior cervical surgery and developed corresponding solutions. The next step involves applying these measures in clinical practice to improve patient prognosis and elevate the quality of care.