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成年患者临床护理人员鼻饲喂养实践:一项中国多中心横断面调查

Clinical nurses' nasogastric feeding practices in adults: a multicenter cross-sectional survey in China.

作者信息

Xu Li-Chun, Huang Xiao-Jin, Lin Bi-Xia, Zheng Jun-Yi, Zhu Hai-Hua

机构信息

Zhongshan Hospital, Xiamen University, Xiamen, Fujian, China.

Xiamen Cardiovascular Hospital Xiamen University, Xiamen, Fujian, China.

出版信息

J Int Med Res. 2020 Apr;48(4):300060520920051. doi: 10.1177/0300060520920051.

Abstract

OBJECTIVE

We aimed to investigate practices of nasogastric tube (NGT) intubation and feeding for adults by clinical nurses in China.

METHODS

A self-designed and validated questionnaire comprising 30 questions was distributed to 560 clinical nurses in three comprehensive hospitals of Xiamen, China. The questionnaire covered participants' demographic characteristics, NGT placement, administration of enteral nutrition (EN), and monitoring or management of feeding intolerance.

RESULTS

A total 464 (82.9%) questionnaires were completed; 36.2% of nurses used nose-ear-xiphoid and 79.5% forehead-xiphoid measurement to define the internal length of the NGT. Many participants still used traditional methods to confirm NGT placement (auscultation of injected air 50.2%, bubble test 34.7% and observing feeding tube aspirate 34.3%). Bolus feeding was the most commonly used technique to administer EN. A total 97.0% of all nurses used syringes to measure gastric residual volume (GRV), and 62.7% measured GRV every 4-8 hours. The most frequently used GRV threshold values were 200 mL (44.6%) and 150 mL (25.2%). Most nurses stopped feeding immediately when encountering high GRV (84.3%) or diarrhea (45.0%). The nasogastric feeding practices of many clinical nurses were not consistent with international guidelines.

CONCLUSIONS

Our study can provide an impetus for nursing administrators to revise their nasogastric feeding procedures, to promote compliance with evidence-based guidelines.

摘要

目的

我们旨在调查中国临床护士对成人进行鼻胃管插管和喂食的操作情况。

方法

向中国厦门三家综合医院的560名临床护士发放了一份自行设计并验证的包含30个问题的问卷。该问卷涵盖了参与者的人口统计学特征、鼻胃管放置、肠内营养(EN)的给予以及喂食不耐受的监测或管理。

结果

共完成464份(82.9%)问卷;36.2%的护士使用鼻-耳-剑突和79.5%使用前额-剑突测量法来确定鼻胃管的插入长度。许多参与者仍使用传统方法来确认鼻胃管位置(注入空气听诊占50.2%,气泡试验占34.7%,观察抽出的饲管液占34.3%)。推注喂养是给予肠内营养最常用的技术。所有护士中有97.0%使用注射器测量胃残余量(GRV),62.7%每4 - 8小时测量一次GRV。最常使用的GRV阈值为200 mL(44.6%)和150 mL(25.2%)。大多数护士在遇到高GRV(84.3%)或腹泻(45.0%)时会立即停止喂食。许多临床护士的鼻胃管喂养操作与国际指南不一致。

结论

我们的研究可为护理管理人员修订鼻胃管喂养程序提供动力,以促进遵循循证指南。

相似文献

2
Nasogastric feeding practices: a survey using clinical scenarios.经鼻胃管喂养操作实践:基于临床情景的调查。
Int J Nurs Stud. 2012 Mar;49(3):310-9. doi: 10.1016/j.ijnurstu.2011.09.014. Epub 2011 Oct 5.

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