中华护理杂志 ›› 2021, Vol. 56 ›› Issue (12): 1852-1859.DOI: 10.3761/j.issn.0254-1769.2021.12.016
费朝廷(
), 刘艺, 朱丽群(
), 庄若, 眭升, 黄贤凤, 朱竺枝, 张艳红
收稿日期:2021-02-17
出版日期:2021-12-15
发布日期:2021-12-20
通讯作者:
朱丽群,主任护师,E-mail: 2495409460@qq.com作者简介:费朝廷:女,硕士,E-mail: Feichaoting888@163.com
基金资助:
FEI Chaoting(
), LIU Yi, ZHU Liqun(
), ZHUANG Ruo, SUI Sheng, HUANG Xianfeng, ZHU Zhuzhi, ZHANG Yanhong
Received:2021-02-17
Online:2021-12-15
Published:2021-12-20
摘要:
目的 检索、评价和总结吞咽障碍患者服药管理的最佳证据。方法 运用循证护理的方法,针对吞咽障碍患者服药管理提出问题,系统检索UpToDate、BMJ、乔安娜布里格斯研究所(Joanna Briggs Institute,JBI)图书馆、Co-chrane Library、加拿大安大略注册护士协会网站、英国国家临床医学研究所指南库、苏格兰学院间指南网、美国国立指南网、国际网络指南网、加拿大医学会临床实践指南、美国心脏/脑卒中协会网站、PubMed、CINAHL、英国NEWT网站、中国生物医学文献数据库、医脉通、中国知网等数据库或网站,检索时限为建库至2021年1月,文献类型涵盖临床决策、临床实践指南、证据总结、系统评价、专家共识。由3名研究者对检索到的文献进行评价和证据提取。 结果 共纳入12篇文献,其中临床决策2篇、指南2篇、证据总结6篇、专家共识2篇。总结了8个方面的最佳证据,包括医护人员教育和培训、用药前筛查和评估、多学科合作、代偿性方法、口服固体剂型的选择、碾碎药物的管理、胃肠营养管用药、用药效果监测和记录。结论 该研究针对吞咽障碍患者服药管理进行证据总结,为建立吞咽障碍患者服药规范流程、实践标准提供循证依据,保证患者的用药安全。
费朝廷, 刘艺, 朱丽群, 庄若, 眭升, 黄贤凤, 朱竺枝, 张艳红. 吞咽障碍患者服药管理的最佳证据总结[J]. 中华护理杂志, 2021, 56(12): 1852-1859.
FEI Chaoting, LIU Yi, ZHU Liqun, ZHUANG Ruo, SUI Sheng, HUANG Xianfeng, ZHU Zhuzhi, ZHANG Yanhong. Summary of best evidence of medication administration in patients with swallowing disorders[J]. Chinese Journal of Nursing, 2021, 56(12): 1852-1859.
| [1] |
Lau ETL, Steadman KJ, Cichero JAY, et al. Dosage form modification and oral drug delivery in older people[J]. Adv Drug Deliv Rev, 2018, 135:75-84.
DOI URL |
| [2] |
Lohmann K, Ferber J, Haefeli MF, et al. Knowledge and training needs of nurses and physicians on unsuitable drugs for patients with dysphagia or feeding tubes[J]. J Clin Nurs, 2015, 24(19/20):3016-3019.
DOI URL |
| [3] |
Liabeuf S, Gras V, Moragny J, et al. Ulceration of the oral mucosa following direct contact with ferrous sulfate in elderly patients:a case report and a review of the French National Pharmacovigilance Database[J]. Clin Interv Aging, 2014, 9:737-740.
DOI PMID |
| [4] | Scottish Intercollegiate Guidelines Network. Management of patients with stroke:identification and management of dysphagia.a national clinical guideline[EB/OL]. [2010-06-01][2020-10-29]. https://www.sign.ac.uk/media/1057/sign119.pdf. |
| [5] | Winstein CJ, Stein J, Arena R, et al. Guidelines for adult stroke rehabilitation and recovery. American:AHA/ASA Guideline[EB/OL].(2016-05-04)[2020-10-29]. http://stroke.ahajourn-als.org. |
| [6] | 王轶, 韩柳, 袁翠, 等. 成人ICU患者外周动脉导管留置与维护的最佳证据总结[J]. 中华护理杂志, 2020, 55(4):600-606. |
| Wang Y, Han L, Yuan C, et al. Best evidence summary for peripheral arterial catheterization insertion and maintenance in adult ICU patients[J]. Chin J Nurs, 2020, 55(4):600-606. | |
| [7] | AGREE II-Users Manual and 23-item Instrument[EB/OL].(2017- 10-15)[2020-10-29]. https://www.agreetrust.org/about-the-agree-enterprise/intro-duction-to-agree-ii/. |
| [8] | The Joanna Briggs Institute(JBI)[EB/OL].(2017-07-15)[2020-10-29]. http://joannabriggs.org/research/critical-appraisal-tools.html. |
| [9] | 米元元, 沈月, 王宗华, 等. 机械通气患者误吸预防及管理的最佳证据总结[J]. 中华护理杂志, 2018, 53(7):849-856. |
| Mi YY, Shen Y, Wang ZH, et al. Evidence summary for aspiration patients receiving mechanical ventilation[J]. Chin J Nurs, 2018, 53(7):849-856. | |
| [10] | Goldsmith T, Cohen AK. Swallowing disorders and aspiration in palliative care:assessment and strategyies for management[EB/OL].(2020-07-27)[2020-09-30]. https://www-uptodate-com.autorpa.kfsyscc.org/con-tents/swallowing-disorders-and-aspiration-in-palliative-care-assessment-and-strategies-for-management?search=Swallowing%20disorders%20and%20aspiration%20in%20palliative%20care%EF%BC%9AAssessment%20and%20 strategies%20for%20management&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1. |
| [11] | Lembo AJ. Oropharyngeal dysphagia: linical features,diagnosis,and management[EB/OL].(2020-10-18)[2020-11-29]. https://www-uptodate-com.autor-pa.kfsyscc.org/contents/oropharyngeal-dy-sphagia-clinical-features-diagnosis-and-management?search=Swa-llowing%20disorders%20and%20aspiration%20in%20palliative%20care%EF%BC%9AAssessment%20and%20strategies %20for%20management&source=search_result&selectedTitle=7~150&usage_type= default&display_rank=7. |
| [12] | Khanh-Dao LL. Oral medication:swallowing difficulties(dyspha-gia)[EB/OL].(2020-07-29)[2020-11-19]. https://ovidsp.dc2.ovid.com/ovid-a/ovidweb.cgi?&S=LFABFPIBMEEBAIKOJPOJIHHGJIGNAA00&Link+Set=S.sh.18%7c1%7csl_190. |
| [13] | Koh G. Swallowing impairment(older person):alteration of oral dose form medication[EB/OL].(2020-04-01)[2020-11-19]. https://ovidsp.dc2.ovid.com/ovid-a/ovidweb.cgi?&S=LFABFPIB-MEEBAIKOJPOJIHHGJIGNAA00&Link+Set=S.sh.38%7c1%7csl_190. |
| [14] | Kunde L. Swallowing impairmen(older person):administration of medications in food and beverages[EB/OL].(2020-04-19)[2020-11-19]. ttps://ovidsp.dc2.ovid.com/ovid-a/ovidweb.cgi?&S=LFABFPIBMEEBAIKOJPOJIHHGJIGNAA00&Link+Set=S.sh.42%7c1%7csl_190. |
| [15] | Mei LY. Medication management in residential aged care[EB/OL].(2018-05-10)[2020-11-19]. https://ovidsp.dc2.ovid.com/ovid-a/ovidweb.cgi?&S=LFABFPIBMEEBAIKOJPOJIHHGJIGNAA00&Link+Set=S.sh.65%7c1%7csl_190. |
| [16] | Sivapuram MS. Dysphagia(older person):management[EB/OL].(2020-01-23)[2020-11-19]. http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=jbi&NEWS=N&AN=JBI14521. |
| [17] | Lockwood C. Percutaneous endoscopic gastronomy(PEG) tube:administration of enteral feed[EB/OL].(2020-05-12)[2020-11-19]. https://ovidsp.dc2.ovid.com/ovid-a/ovidweb.cgi?&S=LFABF-PIBMEEBAIKOJPOJIHHGJIGNAA00&Link+Set=S.sh.58%7c3%7csl_190. |
| [18] | 中国吞咽障碍康复评估与治疗专家共识组. 中国吞咽障碍评估与治疗专家共识(2017年版)[J]. 中华物理医学与康复杂志, 2018, 40(1):1-9. |
| Chinese Expert Consensus Group for Rehabilitation Evaluation and Treatment of Swallowing Disorders. Expert consensus on the assessment and treatment of swallowing disorders in China(2017)[J]. Chin J Phys Med Rehabil, 2018, 40(1):1-9. | |
| [19] | Smyth J. The NEWT guidelines for administration of medication to patients with enteral feeding tubes or swallowing difficulties:General guidelines for administration of medications to patients with swallowing difficulties[EB/OL].(2015-06-01)[2020-11-19]. http://www.newtguidelines.com/SwallowingDifficulties.html. |
| [20] |
Speyer R, Baijens L, Heijnen M, et al. Effects of therapy in oropharyngeal dysphagia by speech and language therapists:a systematic review[J]. Dysphagia, 2010, 25(1):40-65.
DOI PMID |
| [21] |
Gillicuddy A, Crean AM, Sahm LJ. Older adults with difficulty swallowing oral medicines:a systematic review of the literature[J]. Eur J Clin Pharmacol, 2016, 72(2):141-151.
DOI PMID |
| [22] |
Masilamoney M, Dowse R. Knowledge and practice of healthcare professionals relating to oral medicine use in swallowing-impaired patients:a scoping review[J]. Int J Pharm Pract, 2018, 26(3):199-209.
DOI URL |
| [23] |
Forough AS, Wong SYM, Lau ETL, et al. Nurse experiences of medication administration to people with swallowing difficulties living in aged care facilities:a systematic review of qualitative evidence[J]. JBI Database System Rev Implement Rep, 2018, 16(1):71-86.
DOI URL |
| [24] |
Hines S, McCrow J, Abbey J, et al. Thickened fluids for people with dementia in residential aged care facilities[J]. Int J Evid Based Healthc, 2010, 8(4):252-255.
DOI URL |
| [25] |
Phillips NM, Nay R. A systematic review of nursing administration of medication via enteral tubes in adults[J]. J Clin Nurs, 2008, 17(17):2257-2265.
DOI PMID |
| [26] |
van Welie S, Wijma L, Beerden T, et al. Effect of warning sym-bols in combination with education on the frequency of erroneously crushing medication in nursing homes:an uncontrolled before and after study[J]. BMJ Open, 2016, 6(8):e012286.
DOI URL |
| [27] |
Bourdenet G, Giraud S, Artur M, et al. Impact of recommendations on crushing medications in geriatrics:from prescription to administration[J]. Fundam Clin Pharmacol, 2015, 29(3):316-320.
DOI URL |
| [28] |
Koria LG, Zaidi TS, Peterson G, et al. Impact of medication reviews on inappropriate prescribing in aged care[J]. Curr Med Res Opin, 2018, 34(5):833-838.
DOI URL |
| [29] |
Thong MY, Manrique YJ, Steadman KJ. Drug loss while crushing tablets:Comparison of 24 tablet crushing devices[J]. PLoS One, 2018, 13(3):e0193683.
DOI URL |
| [30] |
Fodil M, Nghiem D, Colas M, et al. Assessment of clinical prac-tices for crushing medication in geriatric units[J]. J Nutr Health Aging, 2017, 21(8):904-908.
DOI PMID |
| [31] |
Serrano Santos JM, Poland F, Wright D, et al. Medicines admi-nistration for residents with dysphagia in care homes:a small scale observational study to improve practice[J]. Int J Pharm, 2016, 512(2):416-421.
DOI URL |
| [32] | 吴超君, 缪晶, 张昕童, 等. 成人输液港堵塞预防与处理的证据总结[J]. 中华护理杂志, 2018, 53(3):346-351. |
| Wu CJ, Miao J, Zhang XT, et al. Evidence summary for prevention and management of implantable venous access port occlusion in adult patients[J]. Chin J Nurs, 2018, 53(3):346-351. | |
| [33] |
Kappelle WF, Siersema PD, Bogte A, et al. Challenges in oral drug delivery in patients with esophageal dysphagia[J]. Expert Opin Drug Deliv, 2016, 13(5):645-658.
DOI PMID |
| [1] | 秦春兰, 吴振云, 钱红英, 赵茜, 孙锦庭. 慢性阻塞性肺疾病患者疾病自我控制体验的质性研究[J]. 中华护理杂志, 2025, 60(9): 1093-1098. |
| [2] | 梁元元, 高兴莲, 戴张章, 周荣超, 胡娟娟, 王曾妍, 沈剑辉. 医院手术器械管理的最佳证据总结[J]. 中华护理杂志, 2025, 60(8): 1005-1011. |
| [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] | 王婷, 王佳婷, 金爱云, 朱霞明, 方云, 汪靖, 田菲, 濮益琴, 万滢, 贺瑾, 颜霞. 自体造血干细胞移植术后患者护理随访清单的构建及初步应用[J]. 中华护理杂志, 2025, 60(8): 914-920. |
| [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] | 盛婉婷, 王蕊, 赵玉晓, 戚鹏菲, 高祀龙, 冯娟, 吕伯瀚, 牛群, 王刚. 中等长度静脉导管不同尖端位置应用效果的Meta分析[J]. 中华护理杂志, 2025, 60(8): 990-997. |
| [7] | 严雪芹, 曹松梅, 周芳芳, 朱丽群, 陈成, 朱梦雪, 张艳红, 梁怡青, 柏素萍. 手部烧伤患者手功能早期康复管理的最佳证据总结[J]. 中华护理杂志, 2025, 60(8): 998-1004. |
| [8] | 王奕, 王小惠, 王娟, 王晓峰, 葛静玲. 卵巢癌术后患者自我管理问题清单的构建及应用研究[J]. 中华护理杂志, 2025, 60(7): 806-812. |
| [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] | 雷丹, 卞薇, 王宗华, 苏君, 万君丽, 王露. 角膜溃疡患者互联网+精准症状管理方案的构建及应用研究[J]. 中华护理杂志, 2025, 60(6): 688-695. |
| [13] | 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. |
| [14] | 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. |
| [15] | 王雯静, 郝妩媚, 台靖宇, 董倩, 郭爱敏. 慢性阻塞性肺疾病患者吸入药物治疗体验的Meta整合[J]. 中华护理杂志, 2025, 60(5): 545-551. |
| 阅读次数 | ||||||
|
全文 |
|
|||||
|
摘要 |
|
|||||