中华护理杂志 ›› 2022, Vol. 57 ›› Issue (3): 261-264.DOI: 10.3761/j.issn.0254-1769.2022.03.001

• 重症护理专题 •    下一篇

神经重症患者肠内喂养护理专家共识

中华护理学会重症护理专业委员会, 北京医学会肠外肠内营养学分会护理学组, (执笔:刘芳 高岚 王晓英 王宇娇 邓秋霞 苗凤茹 张晓梅 孙蕊 孙红 郭淑丽)   

  1. 100053 北京市 首都医科大学宣武医院神经内科(刘芳,王晓英,孙蕊);吉林大学第一医院神经内科(高岚,王宇娇,邓秋霞);航天中心医院神经内科(苗凤茹);南方医科大学南方医院神经内科(张晓梅);中国医学科学院北京协和医院组织处(孙红),基本外科(郭淑丽)
  • 收稿日期:2021-02-24 出版日期:2022-02-10 发布日期:2022-01-24
  • 通讯作者: 高岚,E-mail:1329695978@qq.com
  • 基金资助:
    吉林大学医院管理研究项目(201918)

Expert consensus on enteral feeding nursing for patients with severe neurological diseases

Intensive Care Committee of Chinese Nursing Association, Beijing Society of Parenteral and Enteral Nutrition Nursing Group, (Writing Committee: LIU Fang, GAO Lan, WANG Xiaoying, WANG Yujiao, DENG Qiuxia, MIAO Fengru, ZHANG Xiaomei, SUN Rui, SUN Hong, GUO Shuli)   

  • Received:2021-02-24 Online:2022-02-10 Published:2022-01-24

摘要:

目的 形成神经重症患者肠内喂养护理专家共识,推动护士规范、安全、有效地实施肠内喂养,满足患者营养需求。 方法 检索、评价和汇总神经重症患者肠内喂养护理证据,提取相关的推荐意见,形成共识初稿,通过2轮德尔菲专家函询和专家论证会,根据专家建议进行分析、修改及完善,形成共识终稿。结果 函询专家积极系数为100%,专家判断系数为0.93,熟悉程度为0.88,权威系数为0.91。肯德尔和谐系数为0.256~0.278,具有统计学意义(P<0.05)。最终形成的共识内容包括神经重症患者肠内喂养护理评估、喂养方式的选择、营养液输注、并发症的识别与护理、停止管饲喂养指标5个方面。结论 该共识实用性较强,可为神经重症患者肠内喂养临床护理实践和质量控制提供指导依据。

关键词: 神经重症, 肠内喂养, 护理, 专家共识

Abstract:

Objective To form an expert consensus of enteral feeding and nursing care for patients with severe neurological diseases,and to promote the standardized,safe and effective implementation of enteral feeding by neuro intensive nursing personnel,so as to provide effective nutritional support for patients. Methods The evidence in this field was searched,evaluated and summarized to extract the recommendations related to enteral feeding in patients with severe neurological diseases. The first draft of consensus was formed. Through 2 rounds of Delphi expert consultations and expert demonstration meetings,the expert suggestions were analyzed,modified and improved to form the final draft of consensus. Results The positive coefficient of inquiry experts was 100%;the coefficient of expert judgment was 0.93;the degree of familiarity was 0.88;the coefficient of authority was 0.91. The concordance coefficient of Kendall was 0.256~0.278,which was statistically significant(P<0.05). The final consensus included the evaluation of enteral feeding care for patients with several neurological illness,selection of feeding methods,nutrient solution infusion,identification and care of complications,and indicators for terminating tube feeding. Conclusion This consensus provides guidance for clinical nursing practice and quality control of enteral feeding in critically ill patients.

Key words: Severe Neurosis, Enteral Feeding, Nursing Care, Expert Consensus