Evidence-based nursing practice for prevention and management of enteral nutrition feeding intolerance in patients after upper gastrointestinal surgery
10.3760/cma.j.cn115682-20210219-00738
- VernacularTitle:上消化道术后患者肠内营养喂养不耐受预防及管理的循证护理实践
- Author:
Li KANG
1
;
Cuiling WANG
;
Jia TIAN
;
Ya WEN
;
Jianying TIAN
Author Information
1. 山西医科大学护理学院，太原 030001
- Keywords:
Nutritional support;
Upper gastrointestinal surgery;
Enteral nutrition;
Feeding intolerance;
Evidence-based nursing
- From:
Chinese Journal of Modern Nursing
2021;27(35):4811-4817
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To apply the best evidence for prevention and management of enteral nutrition feeding intolerance in patients after upper gastrointestinal surgery to clinical practice and to evaluate its clinical effects.Methods:Guided by the clinical evidence practice application model of the Joanna Briggs Institute (JBI) Evidence-based Healthcare Centre in Australia, the best appropriate evidence was selected based on expert advice and evidence-based practice protocols were developed. The convenient sampling method was adopted to select 84 patients and 21 nurses who were admitted to the Department of General Surgery in a Class Ⅲ Grade A hospital in Taiyuan from September to December 2020 as the research objects. A baseline review of 42 patients and 21 nurses admitted from September to October 2020 was conducted, and education, training and quality supervision were conducted to promote practice change. A total of 42 patients and 21 nurses (same as before) admitted from November and December 2020 were reviewed. Incidence of enteral feeding intolerance, the time to recovery of intestinal function, the knowledge, attitude and practice of nurses towards prevention and management of enteral feeding intolerance and implementation of audit indicators among nurses were compared before and after the application of the program.Results:The incidence of abdominal distension, diarrhea and feeding intolerance in patients after the application of the evidence was lower than that in patients before the application of the evidence, and the difference was statistically significant ( P<0.05) . The first anal exhaust time and first anal defecation time of patients after the application of the evidence were (59.02±17.19) and (68.10±19.98) h, which were shorter than those before the application of evidence (78.79±22.34) and (82.76±22.35) h, and the differences were statistically significant ( P<0.01) . After the application of the evidence, the scores of all dimensions of nurses' knowledge, belief and practice questionnaire for the prevention and management of feeding intolerance were higher than those before the application of evidence, and the differences were statistically significant ( P<0.05) . The implementation rates of the 11 audit indicators were improved from 0-78.57% to 80.95%-100%. Conclusions:The best-evidence based prevention and management strategies of enteral nutrition intolerance in patients after upper gastrointestinal surgery can be applied to clinical practice to standardize the work behavior of nurses in implementing enteral nutrition and reduce the incidence of feeding intolerance in patients.
