Walton Janice, Burns Denise, Gaehle Kay E
Janice Walton, BSN, RN, CGRN, is Staff Nurse, Endoscopy Lab, Memorial Hospital, Belleville, Illinois. Denise Burns, BSN, RN, CGRN, is Staff Nurse, Endoscopy Lab, Memorial Hospital, 4500 Memorial Drive, Belleville, Illinois. Kay E. Gaehle, PhD, RN, is Research Consultant, Memorial Hospital, and Associate Professor of Nursing at Southern Illinois University, Edwardsville, Belleville, Illinois.
Gastroenterol Nurs. 2017 Sep/Oct;40(5):411-419. doi: 10.1097/SGA.0000000000000233.
The incidence of Clostridium difficile infection is on the rise worldwide, causing high mortality rates and costing patients, hospitals, and insurance companies millions of dollars annually. Fecal microbiota transplants successfully treat recurrent C. difficile infections unresponsive to standard pharmacologic treatment such as flagyl, vancomycin, or rifaximin. Evidence in the literature provided the foundation for the development and refinement of this fecal microbiota transplant protocol. During the initial phase of the project, the protocol included patient selection criteria, donor screening/selection, infection control, fecal processing and delivery, and patient pre and postprocedure education. This article highlights the second phase of prospective testing of a nurse-driven protocol to implement fecal microbiota transplantation in patients with recurrent C. difficile infection. All stages of the protocol are explained as well as rationale for component parts to achieve successful patient outcomes when the protocol is carefully followed.
艰难梭菌感染的发病率在全球范围内呈上升趋势，导致高死亡率，每年给患者、医院和保险公司造成数百万美元的损失。粪便微生物群移植成功地治疗了对甲硝唑、万古霉素或利福昔明等标准药物治疗无反应的复发性艰难梭菌感染。文献中的证据为该粪便微生物群移植方案的制定和完善提供了基础。在项目的初始阶段，该方案包括患者选择标准、供体筛查/选择、感染控制、粪便处理和输送，以及患者术前和术后教育。本文重点介绍了一项由护士主导的方案的前瞻性测试的第二阶段，该方案用于在复发性艰难梭菌感染患者中实施粪便微生物群移植。文中解释了该方案的所有阶段以及各组成部分的原理，以便在严格遵循该方案时实现成功的患者治疗结果。
