Compliance and effectiveness of the clinical practice guidelines for enteral nutrition support in acute stroke patients with dysphagia
10.3760/cma.j.issn.1006-7876.2012.12.003
- VernacularTitle:神经疾病肠内营养支持操作规范的依从性与有效性
- Author:
Yingying SU
;
Daiquan GAO
;
Liansheng MA
;
Huanhuan FENG
;
Lin WANG
;
Yunzhou ZHANG
;
Ling WANG
;
Fang LIU
;
Xiuhai GUO
;
Hong CHANG
;
Min XU
;
Limei FAN
;
Qian ZHANG
- Publication Type:Journal Article
- Keywords:
Stroke;
Dysphagia;
Enteral nutrition;
Guidelines;
Outcomes
- From:
Chinese Journal of Neurology
2012;(12):843-848
- CountryChina
- Language:Chinese
-
Abstract:
Objective To implement and evaluate evidence-based guidelines for enteral nutrition support in acute stroke patients with dysphagia.Methods This study is a prospective before and after comparison study.Collected 200 acute stroke patients with dysphagia and divided them into test group (trained medical staffs) and control group(untrained medical staffs) equally according to the time order.Two groups of 100 patients were surveyed using a checklist before and after implementation of 10 guidelines about nutrition support.Before the implementation of guidelines,the staffs were enforced training,and summarized regularly.Compliances with guidelines by doctors and nurses were compared,and outcomes of patients were assessed.Results Compared with the control group,the correct implementation of the project significantly improved in the experimental group on nutritional risk screening (92.0％,64.0％; x2 =22.840),nutritional supplements selection (80.0％,48.0％; x2 =22.220),nutrition infusion methods (90％,18％ ; x2 =1.040) and nutrition infusion adjustment (abdominal distension/adjusted:21/10,6/4;x2 =9.634,constipation/adjusted:41/40,57/53 ; x2 =5.122,all P ＜ 0.05).The mortality rate,poor prognosis and length of stay in department of neurology intensive care unit and in hospital were not significant different between the experimental group and the control group.The incidence of hospital-acquired pneumonia was significantly lower in the experimental group (44.3％) than that in the control group (67.5％,x2 =7.281,P =0.007),but other patient outcomes were unaffected significantly.Conclusion Implementation of evidence-based guidelines for enteral nutrition support in acute stroke patients with dysphagia is associated with improvements in clinical quality and selected patient outcomes.
