住院新生儿母乳院外管理的循证实践

doi:10.3761/j.issn.0254-1769.2022.22.001

摘要/Abstract

摘要：

目的将住院新生儿母乳院外管理最佳证据应用于临床实践并评价其效果。方法运用循证护理的方法，于2021年9月—2022年2月通过证据获取、现状审查、证据引入和效果评价4个阶段将证据应用于临床，比较循证实践前后温州市某三级甲等医院新生儿科住院新生儿母乳相关感染发生率、护士及产妇母乳院外管理知识问卷得分、护士及产妇对审查指标的执行情况。结果最终纳入21条证据、18条审查指标。循证实践后，新生儿母乳相关感染发生率由5.81%下降至0，差异有统计学意义（P=0.026）;护士及产妇母乳院外管理相关知识问卷得分分别由（70.1±5.4）、（55.8±8.3）分提升至（87.6±5.0）、（74.5±6.2）分，差异具有统计学意义（t=10.606，P<0.001;t=8.055，P<0.001）;除条目8、13、16外，住院新生儿母乳院外管理审查指标执行率均上升至80%以上。结论实施基于证据的循证实践能够规范产妇母乳采集、储存、运送行为，提高护士对母乳的监管力度，从而减少母乳被污染的风险，保证母乳质量安全。

关键词: 重症监护病房, 新生儿, 母乳喂养, 院外管理, 循证护理学, 新生儿护理

Abstract:

Objective To apply the best evidence for out-hospital management of breast milk in hospitalized neonates to clinical practice and to evaluate its effects. Methods We used the method of evidence-based nursing to obtain the best evidence. From September 2021 to February 2022，the evidence was applied to the clinical practice through 4 steps，including evidence acquisition，baseline evaluation，evidence introduction，and after-effect evaluation. The incidence of breast milk-related infection，nurses and maternal women’s cognitive level of out-hospital management about breast milk，the implementation rate of review items about maternal women were compared before and after the application of evidence-based practice. Results We finally included 21 pieces of evidence，with a total of 18 review indicators. The incidence of breast milk-related infection decreased from 5.81% to 0（P=0.026）;the scores of nurses and maternal women on out-hospital management of breastfeeding increased from（70.1±5.4） and（55.8±8.3） to（87.6±5.0） and（74.5±6.2）（t=10.606，P<0.001;t=8.055，P<0.001）;except for items 8，13，and 16，the compliance of out-hospital management review indicators for breastfeeding increased to more than 80%. Conclusion Evidence-based practice can standardize the correct operation of family members’ breast milk collection，storage，and transportation，thereby reducing the risk of breast milk contamination and ensuring the quality and safety of breast milk.

Key words: Intensive Care Units, Neonatal, Breast Feeding, Out-Hospital Management, Evidence-Based Nursing, Neonatal Nursing

黄小夏, 冯小芳, 胡思思, 陈霜, 孙彩霞. 住院新生儿母乳院外管理的循证实践[J]. 中华护理杂志, 2022, 57(22): 2693-2699.

HUANG Xiaoxia, FENG Xiaofang, HU Sisi, CHEN Shuang, SUN Caixia. Evidence-based practice in out-hospital management of breast milk for hospitalized neonates[J]. Chinese Journal of Nursing, 2022, 57(22): 2693-2699.

图/表 2

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