Abstract:

Objective To retrieve,appraise and summarize the best evidence of medication management in patients with swallowing disorders. Methods Using the method of evidence-based nursing for swallowing disorders patients,the problem of standard management of taking medicine was put forward. Evidence-based nursing methods were used to search UpToDate,BMJ,JBI,Cochrane Library,Ontario Registered Nurses Association of Canada,British National Institute of Clinical Medicine Guide Library,Scottish Intercollegiate Guidelines Network,National Guideline Clearinghouse,Guidelines International Network,Canadian Medical Association,American Heart Association/American Stroke Association,PubMed,CINAHL,UK NEWT website,Chinese Biology Medical literature database,Yimaitong,China Knowledge Network and other databases including all relevant documents from the date of database establishment to January 2021,covering clinical recommended practice,guideline,evidence summary,systems evaluation,expert consensus. The retrieved literature was evaluated by 3 researchers,and the literature that met the quality standards was extracted for evidence. Results A total of 12 pieces of literature were included,including 2 clinical decisions,2 guidelines,6 evidence summaries,and 2 expert consensused. The best evidence was summarized in 8 areas,including education and training of health care personnel,pre-medication screening and evaluation,multidisciplinary collaboration,compensatory methods,selection of oral solid dosage forms,administration of crushing drugs,gastrointestinal nutrition tube administration,and monitoring and recording of medication effects. Conclusion This study summarized the evidence of the normative management of medication for patients with swallowing disorders,so as to provide evidence-based bases for medical institutions to establish the practice standard of medication procedures for patients with swallowing disorders,and to ensure the safety of medication for patients.

Key words: Dysphagia, Medication, Standardization, Management, Evidence-Based Nursing

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。

关键词: 吞咽障碍, 服药, 规范, 管理, 循证护理