重症患者早期肠内营养耐受性评估及管理方案的构建
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摘要
目的构建重症患者早期肠内营养耐受性评估及管理方案。方法检索国内外数据库,获取和评价肠内营养相关文献,经课题组讨论,制订肠内营养方案初稿,采用德尔菲法对肠内营养专家进行2轮咨询。结果形成重症患者早期肠内营养耐受性评估及管理方案,包括2个一级指标、8个二级指标、20个三级指标;2轮专家咨询的权威系数分别为0.937和0.934,专家协调系数为0.119和0.112。结论专家意见协调程度好,权威性高,可为重症患者早期肠内营养耐受性评估及管理提供依据。
Objective To establish early enteral nutrition tolerance assessment and graded management for critically ill patients. Methods The first draft of management program was established by review of related original studies at home and abroad and group discussion. Two rounds of expert consultation were conducted via Delphi method to finalize the management program. Results The management program consisted of2 first-level items,12 second-level items and 30 third-level items. The expert authority scores of two rounds were 0.937 and 0.934.The expert coordination coefficients were 0.119 and 0.112. Conclusion There were high levels of coordination,enthusiasm,and authority in experts. The management program can be used as a basis for comprehensive assessment and graded management for critically ill patients.
Objective To establish early enteral nutrition tolerance assessment and graded management for critically ill patients. Methods The first draft of management program was established by review of related original studies at home and abroad and group discussion. Two rounds of expert consultation were conducted via Delphi method to finalize the management program. Results The management program consisted of2 first-level items,12 second-level items and 30 third-level items. The expert authority scores of two rounds were 0.937 and 0.934.The expert coordination coefficients were 0.119 and 0.112. Conclusion There were high levels of coordination,enthusiasm,and authority in experts. The management program can be used as a basis for comprehensive assessment and graded management for critically ill patients.
引文
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[13]Padar M,Uusvel G,Starkopf L,et al.Implementation of enteral feeding protocol in an intensive care unit:before-and-after study[J].World J Crit Care Med,2017,6(1):56-64.
[14]邓艳红,赵丽萍,郭亮,等.静脉治疗专科护士核心能力评价指标体系的构建[J].中华护理杂志,2018,54(4):467-472.
[15]杨丽平,张彩云,张志刚,等.机械通气患者床头抬高不同角度效果的Meta分析[J].国际护理学杂志,2017,36(14):1873-1878,1905.
[16]Singer P,Blaser AR,Berger MM,et al.ESPEN guideline on clinical nutrition in the intensive care unit[J].Clinical Nutrition,2019,38(1):48-79.
[17]Kose E,Hirai T,Seki T.Assessment of aspiration pneumonia using the Anticholinergic Risk Scale[J].Geriatr Gerontol Int,2018,18(8):1230-1235.
[18]林佩贤.Excel在德尔菲法资料统计分析中的应用与评价[D].广州:暨南大学,2009.
[19]国家卫生计生委.护理分级[S].213.
[2]Pu H,Doig GS,Heighes PT,et al.Early enteral nutrition reduces mortality and improves other key outcomes in patients with major burn injury[J].Critical Care Med,2018,46(12):2036-2042.
[3]叶向红,彭南海,江方正,等.重症急性胰腺炎合并腹腔高压患者早期肠内营养耐受性的管理[J].中华护理杂志,2016,51(12):1439-1442.
[4]朱丽,高纯,冯永东,等.肠内营养耐受性评估表对胃癌术后患者早期肠内营养耐受性的影响[J].现代临床护理,2015,14(7):18-22.
[5]Organization WH.International classification of functioning,disability and health:ICF[M].Geneva:World Health Organization,2001.
[6]Bulechekgm DJ.Nursing Interventions Classification(NIC)[M].New York:Mosby,2012.
[7]胡雁.循证护理学[M].北京:人民卫生出版社,2012.
[8]Newhouse RP,Dearholt SL,Poe SS,et al.Johns hopkins nursing evidence-based practice model and guidelines[M].Indianapolis:The Honor Society of Nursing,Sigma Theta Tau International,2007.
[9]詹森.护理诊断、结局与措施[M].北京:北京大学医学出版社,2010.
[10]于世英,印季良,秦叔逵,等.肿瘤治疗相关呕吐防治指南(2014版)[J].临床肿瘤学杂志,2014,19(3):263-273.
[11]Malbrain ML,Cheatham ML,Kirkpatrick A,et al.Results from the international conference of experts on intra-abdominal hypertension and abdominal compartment syndrome.i.definitions[J].Intensive Care Med,2006,32(11):1722-1732.
[12]Reintam BA,Deane AM,Fruhwald S.Diarrhoea in the critically ill[J].Curr Opin Crit Care,2015,21(2):142-153.
[13]Padar M,Uusvel G,Starkopf L,et al.Implementation of enteral feeding protocol in an intensive care unit:before-and-after study[J].World J Crit Care Med,2017,6(1):56-64.
[14]邓艳红,赵丽萍,郭亮,等.静脉治疗专科护士核心能力评价指标体系的构建[J].中华护理杂志,2018,54(4):467-472.
[15]杨丽平,张彩云,张志刚,等.机械通气患者床头抬高不同角度效果的Meta分析[J].国际护理学杂志,2017,36(14):1873-1878,1905.
[16]Singer P,Blaser AR,Berger MM,et al.ESPEN guideline on clinical nutrition in the intensive care unit[J].Clinical Nutrition,2019,38(1):48-79.
[17]Kose E,Hirai T,Seki T.Assessment of aspiration pneumonia using the Anticholinergic Risk Scale[J].Geriatr Gerontol Int,2018,18(8):1230-1235.
[18]林佩贤.Excel在德尔菲法资料统计分析中的应用与评价[D].广州:暨南大学,2009.
[19]国家卫生计生委.护理分级[S].213.