高级实践护士在危重患者肠内营养治疗中的角色探讨
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摘要
从肠内营养实施前的营养状况与病情的评估,实施过程中的病情观察、健康指导与护理管理,及相关性并发症的预防与管理等方面简述了高级实践护士在危重患者实施肠内营养过程中的工作内容;从高级临床专科护士、教育者、临床顾问、研究者、管理者等不同的高级实践护士角色探讨其实践方式;并且借鉴国内外高级实践护理发展的经验,结合中国国情,探讨了在中国发展肠内营养高级实践护士的临床培养模式,为后期构建一套较完善、科学且可操作性强的我国肠内营养APN培养和实践模式提供借鉴。
Describe the work content of advanced practice nurses in the process of enteral nutrition implementation in critically ill patients from the aspects of nutrition status and condition assessment before enteral nutrition implementation, condition observation, health guidance, nursing management, and prevention and management of related complications during enteral nutrition implementation. Discuss the practice model of advanced practice nurses from different roles, such as advanced clinical nurses, educators, clinical consultants, researchers and managers, etc. Explore the clinical training model for the development of advanced practice nurses in enteral nutrition in China based on the experience of advanced practice nursing development at home and abroad, and combined with China′s national conditions in order to provide a reference for the later construction of a more perfect, scientific and operable APN training and practice model in enteral nutrition in China.
Describe the work content of advanced practice nurses in the process of enteral nutrition implementation in critically ill patients from the aspects of nutrition status and condition assessment before enteral nutrition implementation, condition observation, health guidance, nursing management, and prevention and management of related complications during enteral nutrition implementation. Discuss the practice model of advanced practice nurses from different roles, such as advanced clinical nurses, educators, clinical consultants, researchers and managers, etc. Explore the clinical training model for the development of advanced practice nurses in enteral nutrition in China based on the experience of advanced practice nursing development at home and abroad, and combined with China′s national conditions in order to provide a reference for the later construction of a more perfect, scientific and operable APN training and practice model in enteral nutrition in China.
引文
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[18]郑秋兰,张传来,范定容.ICU患者肠内营养相关性腹泻护理的研究进展[J].护理管理杂志,2017,17(9):640-643.
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[2]万献尧,于凯江,马晓春,等.中国重症加强治疗病房危重患者营养支持指导意见(2006)[J].中华外科杂志,2006,44(17):1167-1177.
[3]姚莉,哈悠悠.ICU危重患者肠内营养的护理[J].中国妇幼健康研究,2017,28(S3):243-244.
[4]彭江琼,唐晓铃,周玲,等.鼻空肠管肠内营养在ICU患者中的护理研究[J].中国现代药物应用,2018,12(7):213-214.
[5]查丽玲,江榕,叶李莎.危重患者肠内营养并发症护理管理的研究[J].实用临床医学,2016,17(9):100-103.
[6]李雷娇,黄迎春,彭南海.临床营养专科护士培养方式探析与管理[J].肠外与肠内营养,2015,22(4):233-235.
[7]陈博,熊茂明,孟翔凌.营养状况评估方法及营养支持指征的研究进展[J].安徽医学,2016,37(10):1305-1308.
[8]徐裕杰,李卡.外科术后经空肠肠内营养不耐受干预的研究进展[J].护理学杂志,2018,33(4):103-106.
[9]杨燕,赵荣华,吴立新.重症监护室患者肠内营养相关性腹泻的影响因素及护理[J].广西医学,2018,40(2):203-206.
[10]刘凯.RICU气管插管患者肠内营养误吸的原因及护理[J].临床医药文献电子杂志,2017,4(47):9231-9232.
[11]苏钰.危重患者肠内营养安全护理管理[J].齐鲁护理杂志,2011,17(12):99-100.
[12]张晨露.NICU肠内营养患者误吸与胃残余的相关性研究[D].太原:山西医科大学,2017.
[13]陶春红,程志强.危重患者肠内营养胃残留量的监测与探讨[J].当代护士:中旬刊,2018,25(4):53-54.
[14]Moreira TV,Mcquiggan M.Methods for the assessment of gastric emptying in critically ill,enteraly fed adults[J].Nutr Clin Pract,2009,24(2):261-273.
[15]杨燕,赵荣华,吴立新.重症监护室患者肠内营养相关性腹泻的影响因素及护理[J].广西医学,2018,40(2):203-206.
[16]危娟,林凤英,莫红平,等.ICU患者肠内营养期间腹泻的相关因素分析[J].中华护理杂志,2015,50(8):954-959.
[17]朱佳莲,叶向红.手术后病人早期肠内营养并发腹泻的相关因素分析及护理[J].肠外与肠内营养,2015,22(4):254-256.
[18]郑秋兰,张传来,范定容.ICU患者肠内营养相关性腹泻护理的研究进展[J].护理管理杂志,2017,17(9):640-643.
[19]黄金月.高级护理实践导论[M].北京:人民卫生出版社,2008:7.