Emergency Department, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Nanfang Nursing Centre for Evidence-Based Practice: A JBI Centre of Excellence, Guangzhou, China.
JBI Evid Implement. 2024 May 1;22(2):175-185. doi: 10.1097/XEB.0000000000000410.
Acute pancreatitis is a major disease that endangers the health and lives of people. Historically, clinical therapy has recommended. that patients with acute pancreatitis remain nil by mouth. As one of the therapies recommended in recent guidelines, early enteral nutrition support reduces the incidence of infectious complications and reduces the risk of severe conditions. However, early enteral nutrition support has not been optimally implemented within clinical practice for acute pancreatitis inpatients.
This evidence implementation project aimed to increase compliance with best practice recommendations for early enteral nutrition support, while standardizing the enteral nutrition support process and reducing the incidence of delayed enteral nutrition.
The project was guided by the JBI Evidence Implementation Framework, which is grounded in the audit and feedback process, as well as a seven-stage structured approach to identifying and managing barriers to compliance with recommended practices.
In the baseline audit, compliance rates were low for all evidence-based audit criteria. Four of the eight criteria showed 0% compliance. However, after implementation, all eight criteria achieved a minimum compliance rate of 60%, with Site 2 achieving 90% to 100% compliance. In addition, nurses improved their knowledge and skills in early enteral nutrition support. The incidence of delayed enteral nutrition also fell from 86.2% to 20.7% at both study sites. The implementation strategy included a training program, psychological interventions, and financial and human resource support.
This project not only significantly improved early enteral nutrition support for acute pancreatitis patients, but also increased nurses' knowledge and practice skills, standardized the process of enteral nutrition support, and reduced the incidence of delayed enteral nutrition.
急性胰腺炎是一种严重危害人们健康和生命的疾病。历史上，临床治疗建议急性胰腺炎患者保持禁食。作为最近指南中推荐的治疗方法之一，早期肠内营养支持可降低感染性并发症的发生率，并降低重症风险。然而，急性胰腺炎住院患者的临床实践中并未最佳实施早期肠内营养支持。
本证据实施项目旨在提高对早期肠内营养支持最佳实践建议的依从性，同时规范肠内营养支持流程并减少延迟肠内营养的发生。
该项目以 JBI 证据实施框架为指导，该框架基于审核和反馈过程以及一个七阶段的结构化方法，用于识别和管理与遵守推荐实践相关的障碍。
在基线审核中，所有基于证据的审核标准的依从率都很低。八项标准中有四项显示为 0%依从。然而，实施后，所有八项标准的最低依从率均达到 60%，站点 2 的依从率达到 90%至 100%。此外，护士提高了他们在早期肠内营养支持方面的知识和技能。延迟肠内营养的发生率也从两个研究地点的 86.2%降至 20.7%。实施策略包括培训计划、心理干预以及财务和人力资源支持。
该项目不仅显著改善了急性胰腺炎患者的早期肠内营养支持，还提高了护士的知识和实践技能，规范了肠内营养支持流程，并降低了延迟肠内营养的发生率。
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