为住院急性胰腺炎患者提供早期肠内营养支持:最佳实践实施项目。

IF 2.7 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Jbi Evidence Implementation Pub Date : 2024-05-01 DOI:10.1097/XEB.0000000000000410
Jieying Xie, Yuhan Cai, Huiying Xu, Yang Peng, Alexa McArthur
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引用次数: 0

摘要

引言急性胰腺炎是危害人们健康和生命的重大疾病。一直以来,临床治疗建议急性胰腺炎患者保持口服零食。作为近期指南推荐的疗法之一,早期肠内营养支持可降低感染性并发症的发生率,并减少出现严重情况的风险。然而,早期肠内营养支持在急性胰腺炎住院患者的临床实践中并未得到最佳实施:本证据实施项目旨在提高早期肠内营养支持最佳实践建议的依从性,同时规范肠内营养支持流程,降低延迟肠内营养的发生率:该项目以 JBI 证据实施框架为指导,该框架以审计和反馈流程为基础,并采用七阶段结构化方法来识别和管理建议实践的合规障碍:结果:在基线审计中,所有循证审计标准的合规率都很低。八项标准中有四项的达标率为 0%。然而,在实施后,所有八项标准的最低达标率都达到了 60%,其中第二站点的达标率达到了 90% 至 100%。此外,护士在早期肠内营养支持方面的知识和技能也得到了提高。在两个研究点,延迟肠内营养的发生率也从 86.2% 降至 20.7%。实施策略包括培训计划、心理干预以及财政和人力资源支持:该项目不仅明显改善了急性胰腺炎患者的早期肠内营养支持,还提高了护士的知识水平和实践技能,规范了肠内营养支持流程,降低了延迟肠内营养的发生率。
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Early enteral nutrition support for patients with acute pancreatitis in the inpatient setting: a best practice implementation project.

Introduction: Acute pancreatitis is a major disease that endangers the health and lives of people. Historically, clinical therapy has recommended. that patients with acute pancreatitis remain nil by mouth. As one of the therapies recommended in recent guidelines, early enteral nutrition support reduces the incidence of infectious complications and reduces the risk of severe conditions. However, early enteral nutrition support has not been optimally implemented within clinical practice for acute pancreatitis inpatients.

Objectives: This evidence implementation project aimed to increase compliance with best practice recommendations for early enteral nutrition support, while standardizing the enteral nutrition support process and reducing the incidence of delayed enteral nutrition.

Methods: The project was guided by the JBI Evidence Implementation Framework, which is grounded in the audit and feedback process, as well as a seven-stage structured approach to identifying and managing barriers to compliance with recommended practices.

Results: In the baseline audit, compliance rates were low for all evidence-based audit criteria. Four of the eight criteria showed 0% compliance. However, after implementation, all eight criteria achieved a minimum compliance rate of 60%, with Site 2 achieving 90% to 100% compliance. In addition, nurses improved their knowledge and skills in early enteral nutrition support. The incidence of delayed enteral nutrition also fell from 86.2% to 20.7% at both study sites. The implementation strategy included a training program, psychological interventions, and financial and human resource support.

Conclusion: This project not only significantly improved early enteral nutrition support for acute pancreatitis patients, but also increased nurses' knowledge and practice skills, standardized the process of enteral nutrition support, and reduced the incidence of delayed enteral nutrition.

Spanish abstract: http://links.lww.com/IJEBH/A177.

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CiteScore
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13.00%
发文量
23
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