ICU中营养支持专科护士护理实践现状的调查研究

doi:10.3761/j.issn.0254-1769.2025.20.012

摘要/Abstract

摘要：

目的调查ICU中营养支持专科护士的护理实践现状，并分析其影响因素，以便改进培训方案，推动护理实践行为向规范化、精准化方向发展。方法采用便利抽样法，于2023年10月—2025年3月选取29个省（区、市）医疗机构ICU中的营养支持专科护士作为调查对象，采用自行编制的ICU中营养支持专科护士护理实践行为调查问卷进行调查，应用SPSS 21.0软件进行描述性分析与多元线性回归分析。结果共发放问卷774份，回收有效问卷766份，有效问卷回收率为98.97%。ICU中营养支持护士护理实践行为调查问卷得分为（90.41±11.82）分。多元线性回归分析结果显示，性别、医院有无营养支持护理小组、科室有无营养支持护理的规范化流程、科室是否明确营养支持护理小组成员的岗位职责、是否将患者的营养支持状况纳入科室质量管理内容是ICU中营养支持专科护士护理实践行为得分的影响因素（P<0.05）。结论 ICU中营养支持专科护士的护理实践行为处于较高水平，但在肠外营养输注、并发症监测方面有待进一步规范。ICU护理管理者应针对临床实践的薄弱环节制订改进策略，强化营养支持培训、完善质量管理方案，进一步提高营养支持专科护士的实践能力。

关键词: 重症监护病房, 营养支持, 专科护士, 影响因素分析, 护理管理研究

Abstract:

Objective To investigate the current nursing practice of nurses specializing in nutritional support in ICUs and analyze their influencing factors in order to improve the training program and promote the development of standardized and precise nursing practice. Methods Convenience sampling method was used to select nutritional support nurses in ICUs in 29 provinces（autonomous regions and municipalities） from October 2023 to March 2025，and the self-developed questionnaire on nursing practice behaviors of nutritional support nurses in ICUs was used to conduct the survey. SPSS 21.0 software was used for descriptive analysis and multiple linear regression analysis. Results A total of 774 questionnaires were distributed，and 766 valid questionnaires were collected，with a recovery rate of 98.97%，and the score of the questionnaire on nursing practice behaviors of nurses specializing in nutritional support in ICU was （90.41±11.82）. The results of multiple linear regression analysis showed that gender，presence of a nutritional support nursing team in the hospital，a standardized process of nutritional support nursing in the department，clear positional responsibilities of the nutritional support nursing team members，and inclusion of the nutritional support status of the patients in the quality management of the department were the factors influencing the nursing practice behavior scores of the nurses specializing in nutritional support in ICUs（P<0.05）. Conclusion Nurses in the ICUs have a high level of nursing practice behavior，but there is a need for further standardization in parenteral nutrition infusion and monitoring of complications. ICU nursing managers should formulate improvement strategies to address the weaknesses of clinical practice，strengthen nutritional support training，and improve the quality management program，and further improve the practical ability of nurses specializing in nutritional support.

Key words: Intensive Care Unit, Nutritional Support, Specialist Nurses, Root Cause Analysis, Nursing Administration Research

周新艺, 孙建华, 邓海波, 王磊, 王晓杰, 王钰, 安然逊, 邵曼娜, 杨妮, 马玉芬, 徐园. ICU中营养支持专科护士护理实践现状的调查研究[J]. 中华护理杂志, 2025, 60(20): 2514-2518.

ZHOU Xinyi, SUN Jianhua, DENG Haibo, WANG Lei, WANG Xiaojie, WANG Yu, AN Ranxun, SHAO Manna, YANG Ni, MA Yufen, XU Yuan. Clinical practice status of nutrition support care among specialized nurses in ICUs[J]. Chinese Journal of Nursing, 2025, 60(20): 2514-2518.

图/表 3

表1 调查对象的一般资料及护理实践行为的单因素分析结果（n=766）

Table 1 General demographic characteristics and univariate analysis of factors influencing clinical practices in nutrition support nursing care among participants（n=766）

表2 ICU中营养支持专科护士护理实践行为调查问卷得分前3位和后3位的条目（n=766）

Table 2 Itemized scores of clinical practices in nutrition support nursing care among participants（n=766）

表3 ICU中营养支持专科护士护理实践行为的多元线性回归分析结果（n=766）

Table 3 Multiple linear regression analysis of factors influencing clinical practices in nutrition support nursing care among participants（n=766）

参考文献 14

[1]	Hagve M, Gjessing P, Ytrebø LM, et al. Nutritional support for cri-tically ill patients in the inten-sive care unit[J]. Tidsskr Nor Lae-geforen, 2020, 140(2):10.
[2]	Singer P, Blaser AR, Berger MM, et al. ESPEN guideline on clinical nutrition in the intensive care unit[J]. Clin Nutr, 2019, 38(1):48-79. DOI PMID
[3]	Al-Dorzi HM, Arabi YM. Nutrition support for critically ill pa-tients[J]. JPEN J Parenter Enteral Nutr, 2021, 45(S2):47-59.
[4]	Li JQ, Sun T, Zuo JT, et al. What influences the implementa-tion of clinical guidelines related to enteral nutrition in the intensive care unit:a mixed-methods systematic review[J]. J Adv Nurs, 2025, 81(3):1172-1183.
[5]	Brouwers MC, Kho ME, Browman GP, et al. Development of the AGREE Ⅱ,part 1:performance,usefulness and areas for impro-vement[J]. CMAJ, 2010, 182(10):1045-1052. DOI PMID
[6]	Taylor BE, McClave SA, Martindale RG, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient:Society of Critical Care Medicine(SCCM) and American Society for Parenteral and Enteral Nu-trition(A.S.P.E.N.)[J]. Crit Care Med, 2016, 44(2):390-438. DOI PMID
[7]	Singer P, Blaser AR, Berger MM, et al. ESPEN practical and partially revised guideline:clinical nutrition in the intensive care unit[J]. Clin Nutr, 2023, 42(9):1671-1689.
[8]	中华医学会重症医学分会. 中国成人ICU患者营养评估与监测临床实践指南[J]. 中华危重病急救医学, 2023, 35(11):1121-1146.
	Chinese Society of Critical Care Medicine. Clinical practice guidelines of nutrition assessment and monitoring for adult patients in the ICU of China[J]. Chin Crit Care Med, 2023, 35 (11):1121-1146. DOI PMID
[9]	王金宁, 刘泽威, 于晓丽, 等. 三级甲等综合医院护士营养知识、态度、行为现状及其影响因素分析[J]. 中国实用护理杂志, 2022, 38(14):1062-1068.
	Wang JN, Liu ZW, Yu XL, et al. Analysis on nutritional know-ledge,attitude and behavior of nurses in class A tertiary hos-pitals and its influencing factors[J]. Chin J Pract Nurs, 2022, 38(14):1062-1068.
[10]	李海群, 朱心怡, 赵梅, 等. 安徽省4所综合医院临床护士营养护理能力现状及影响因素分析[J]. 中华护理杂志, 2022, 57(5):602-608. DOI
	Li HQ, Zhu XY, Zhao M, et al. The current situation and influencing factors of nutritional care competence for clinical nurses from 4 general hospitals in Anhui Province[J]. Chin J Nurs, 2022, 57(5):602-608. DOI
[11]	马尉蓝, 封亚萍, 李鑫, 等. 中美营养支持专科护士的发展现状及启示[J]. 全科护理, 2024, 22(2):242-246.
	Ma WL, Feng YP, Li X, et al. Development status and enligh-tenment of nutrition support specialist nurses in China and the United States[J]. Chin Gen Pract Nurs, 2024, 22(2):242-246.
[12]	宫雪梅, 叶向红, 武燕, 等. 重症患者早期肠内营养喂养中断现状的调查研究[J]. 中华现代护理杂志, 2019, 25(13):1646-1650.
	Gong XM, Ye XH, Wu Y, et al. Current status of feeding interruption of early enteral nutrition among critical patients[J]. Chin J Mod Nurs, 2019, 25(13):1646-1650.
[13]	姚亭, 高亚南, 徐涯鑫, 等. 住院患者肠外营养支持并发症预防的最佳证据总结[J]. 中华护理杂志, 2024, 59(11):1360-1367. DOI
	Yao T, Gao YN, Xu YX, et al. Evidence summary of preven-tion complications for parenteral nutritional support in hospi-talized patients[J]. Chin J Nurs, 2024, 59(11):1360-1367.
[14]	刘芳, 高岚, 王晓英, 等. 神经重症患者肠内喂养护理专家共识[J]. 中华护理杂志, 2022, 57(3):261-264. DOI
	Liu F, Gao L, Wang XY, et al. Expert consensus on enteral feeding nursing for patients with severe neurological diseases[J]. Chin J Nurs, 2022, 57(3):261-264. DOI

[1]	杨静, 王华芬, 卢芳燕, 鲍瑞洁, 朱莉. 肝移植患儿术后营养状况变化的影响因素分析及护理启示[J]. 中华护理杂志, 2025, 60(9): 1113-1119.
[2]	周淼, 陈星, 彭飞, 孙尚雪, 李阳洋. ICU患者中心静脉导管相关血流感染风险预测工具的系统评价[J]. 中华护理杂志, 2025, 60(9): 1132-1139.
[3]	姜珊, 郭彩霞, 郭立华, 赵媛媛, 肖蒙, 杨依玲, 魏春艳, 李硕, 刘殿媛, 尚志丽. 外周静脉留置针并发症风险管理系统的开发与应用[J]. 中华护理杂志, 2025, 60(8): 908-913.
[4]	刘方, 刘云访, 德宗, 皮蓉, 何子涵, 李素云. 肝硬化患者口渴感现状及影响因素研究[J]. 中华护理杂志, 2025, 60(8): 934-939.
[5]	明爱红, 龙秀红, 梁志金, 李砺, 黎凤民, 林思慧, 杨云帆, 王智慧, 冯甜. 国内医疗护理员培训和管理省级政策的文本分析[J]. 中华护理杂志, 2025, 60(8): 960-967.
[6]	周柯冰, 黄晓娇, 闫凤侠. 首发脑卒中恢复期患者症状负担及其影响因素的网络分析[J]. 中华护理杂志, 2025, 60(7): 792-798.
[7]	李红颐, 李雪, 范宇莹, 赵一莎, 李京淑. ICU患者创伤心理反应的潜在剖面及影响因素的混合研究[J]. 中华护理杂志, 2025, 60(7): 842-848.
[8]	陈丽花, 黄瑶, 盛青青, 谭玉凤, 张书琴, 黄小群, 徐蒙蒙. 肺移植术后肠内营养患者喂养不耐受的现状及影响因素分析[J]. 中华护理杂志, 2025, 60(7): 849-855.
[9]	黄婵, 池艳宇, 闵玉娣, 曹培叶, 刘君, 郑镕昕, 张海燕. 基于信息交互需求的护理会诊信息系统的开发及应用[J]. 中华护理杂志, 2025, 60(6): 645-651.
[10]	田君叶, 张霞, 苏莉, 孙路路, 赵瑾, 丁炎明. 专科护士培训信息管理平台的建设与应用研究[J]. 中华护理杂志, 2025, 60(6): 652-658.
[11]	江燕, 谭莉, 邹明君, 冉懋君, 李文苑, 马佳钦. 护士主导的智能化医疗废物暂存设备的研发及实用性评价[J]. 中华护理杂志, 2025, 60(6): 659-665.
[12]	王衍蝶, 曾妃, 梁江淑渊, 顾培培. 肺移植患者骨代谢异常影响因素分析及护理启示[J]. 中华护理杂志, 2025, 60(6): 703-709.
[13]	唐楠, 高远, 苏清清, 宋咪, 邱晨, 邵梦琪. 老年骨质疏松患者再骨折影响因素分析及护理对策[J]. 中华护理杂志, 2025, 60(6): 710-716.
[14]	朱雨涵, 李文佳, 祝雪花. 国内长期照护护理队伍建设现行政策分析[J]. 中华护理杂志, 2025, 60(6): 729-735.
[15]	魏永婷, 田书梅, 杨娇, 余良欢, 倪福, 范雨晴, 肖瑶, 席祖洋, 沙菊艳, 刘聪. 护士循证决策能力量表的汉化及信效度检验[J]. 中华护理杂志, 2025, 60(6): 736-742.