鼻胃管和鼻肠管相关事件：一项针对巴西住院老年人的队列研究。
Nasogastric and Nasoenteric Tube-Related Incidents: A Cohort Study with Hospitalized Brazilian Older Adults.
作者信息
Pereira Roberta Maria de Pina, Storti Luana Baldin, Diniz Maria Angélica Andreotti, Gimenes Fernanda Raphael Escobar, Herrera Claire Nierva, Kusumota Luciana
机构信息
Department of General and Specialized Nursing, University of São Paulo, Ribeirão Preto College of Nursing, São Paulo, Brazil.
出版信息
Florence Nightingale J Nurs. 2025 Mar 10;33:1-9. doi: 10.5152/FNJN.2025.23271.
AIM
The natural aging process, aggravated by the presence of disease and other factors, makes older adults more susceptible to the need for nutritional therapy. Patient safety is a worldwide concern, and older adults are one of the age groups at risk for incidents, especially related to the use of nasogastric and nasoenteric tube feeding.
METHODS
This prospective cohort study aimed to identify and analyze incidents related to the use of nasogastric and nasoenteric tubes, their consequences, and the associated factors in hospitalized older adults. The study was carried out in a public general hospital in the state of São Paulo. Data were collected between October 2016 and November 2017 for this study, and continued until April 2019 in other hospitals involved in the "Multicentre study" through voluntary reporting by healthcare providers, patients or their companions, active searches during ward visits, and reviews of medical records.
RESULTS
The sample consisted of 86 older adults, with a mean age of 71.33 years, high nursing care dependence (39.53%), and a high risk of death (59.30%). The primary reason for tube use among older adults was sensory decline in health (31.40%), followed by lack of appetite and poor oral diet acceptance (22.09%). The most common insertion technique was blind bedside insertion (45.35%), with gastric positioning being the most frequent (44.18%), according to patient records. The prevalence of incidents was 43.02%, among these 35.14% older adults experienced only one incident, 18.91% had two incidents, and 45.95% had three or more incidents. The unplanned removal of the tube was the most frequent event (28.71%), and 56.44% of the cases resulted in mild harm. The death of older adult patients using NGT/NET was not associated with age, sex, level of consciousness, level of nursing care dependence, risk of death, length of monitoring, length of hospital stays, or total incidents.
CONCLUSION
The level of nursing care dependence and age were associated with the occurrence of incidents, highlighting the urgent need to adopt protocols based on updated scientific evidence to guarantee quality and safe care for hospitalized older adults.
目的
自然衰老过程因疾病及其他因素的存在而加剧，使老年人更易需要营养治疗。患者安全是全球关注的问题，老年人是发生事故的高危年龄组之一，尤其是与使用鼻胃管和鼻肠管喂养相关的事故。
方法
这项前瞻性队列研究旨在识别和分析住院老年人使用鼻胃管和鼻肠管相关的事故、其后果及相关因素。该研究在圣保罗州的一家公立综合医院进行。本研究于2016年10月至2017年11月收集数据，并通过医护人员、患者或其同伴的自愿报告、病房查房时的主动搜索以及病历审查，在参与“多中心研究”的其他医院持续至2019年4月。
结果
样本包括86名老年人，平均年龄71.33岁，护理依赖程度高（39.53%），死亡风险高（59.30%）。老年人使用管道的主要原因是健康方面的感觉减退（31.40%），其次是食欲不振和口服饮食接受度差（22.09%）。根据患者记录，最常见的插入技术是床边盲插（45.35%），胃内定位最为常见（44.18%）。事故发生率为43.02%，其中35.14%的老年人仅发生一次事故，18.91%发生两次事故，45.95%发生三次或更多次事故。管道意外拔除是最常见的事件（28.71%），56.44%的病例造成轻度伤害。使用鼻胃管/鼻肠管的老年患者死亡与年龄、性别、意识水平、护理依赖程度、死亡风险、监测时长、住院时间或事故总数无关。
结论
护理依赖程度和年龄与事故发生有关，凸显了迫切需要采用基于最新科学证据的方案，以确保为住院老年人提供优质、安全的护理。
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