评估护理肠内营养的做法和观点在肯尼亚的一家六级医院重症监护室

Daniel Komen
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摘要

背景:充分的营养支持对于重症监护病房(icu)患者的综合管理非常重要。目的:本研究旨在调查普通重症监护病房普遍的肠内营养做法、护士对肠内喂养的认知和知识。研究设计:本研究在肯尼亚一家6级医院的ICU进行。本研究采用横断面描述性研究。材料与方法:发放问卷34份,并对调查结果进行分析。建立了数据库并进行了分析。结果:问卷全部(100%)填写并返回。大多数(32名)护理人员表示了解营养指南。大量(27名)护理人员知道ICU存在营养方案。除禁忌症外,几乎所有护士(82.4%)都选择肠内营养作为首选营养途径。所有医护人员均认为肠内营养应尽早开始(在ICU住院后24-48小时内)。一半(50%)的人认为没有肠音是开始肠内喂养的绝对禁忌症。86%的应答者认为在开始肠内营养前必须通过鼻胃管(赖尔管)。每个人都知道赖尔的管饲方法在他们的ICU是间歇性的大剂量。只有4名护士不知道如何确认赖尔的管位。靠背抬高率为70%。经常检查胃残量,但下一饲料的胃残量各不相同。大多数人表示,未使用的Ryle's管饲24小时后应丢弃。最倾向于(48%)作为个人倡议和CME来提升他们的肠内营养知识。结论:本研究产生的信息有助于确定营养实践差距,并可在必要时用于审查和修订肠内喂养实践。关键词:肠内营养,重症监护,护理,管饲
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Assessing Nursing Enteral Nutrition Practices and Perspectives in An Intensive Care Unit of A Level Six Hospital in Kenya
Background: Adequate nutritional support is important for the comprehensive management of patients in intensive care units (ICUs). Aim: The study was aimed to survey prevalent enteral nutrition practices in the general intensive care unit, nurses' perception, and their knowledge of enteral feeding. Study Design: The study was conducted in the ICU of a level 6 hospital in Kenya. The study design used was crosses sectional descript study. Materials and Methods: thirty four questionnaires were distributed and the results analyzed. A database was prepared and analyzed.Results: all (100%) questionnaires were filled and returned. A majority (32) of staff nurses expressed awareness of nutrition guidelines. A large number (27) of staff nurses knew about existence of nutrition protocols in the ICU. Almost all nurses (82.4%) chose enteral nutrition as their preferred route of nutrition unless contraindicated. All staff nurses were of the opinion that enteral nutrition is to be started at the earliest (within 24-48 h of the ICU stay). Half (50%) were of the thought that the absence of bowel sounds is an absolute contraindication to initiate enteral feeding. Passage of a nasogastric tube (Ryle’s tube) was considered mandatory before starting enteral nutrition by 86% of the respondents. Everyone knew that the method of Ryle's tube feeding in their ICU is intermittent boluses. Only 4 staff nurses were unaware of any method to confirm Ryle's tube position. The backrest elevation rate was 70%. Gastric residual volumes were always checked, but the amount of the gastric residual volume for the next feed to be withheld varied. The majority said that the unused Ryle's tube feed is to be discarded after 24 h. The most preferred (48%) to upgrade their knowledge of enteral nutrition as a personal initiative and CME.Conclusion: Information generated from this study can be helpful in identifying nutrition practices gaps and may be used to review and revise enteral feeding practices where necessary. Keywords: Enteral nutrition, intensive care, nursing, tube feeding
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