ObjectiveTo systematically review the predictors of enteral nutrition feeding intolerance in critically ill patients. MethodsThe PubMed, Web of Science, Cochrane Library, Embase, CNKI, WanFang Data, VIP and CBM databases were searched to collect relevant observational studies from the inception to 6 August, 2022. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.4 software. ResultsA total of 18 studies were included, including 28 847 patients. The results of the meta-analysis showed that gender, age, severity of illness, hypo-albuminemia, length of stay, postpyloric feeding, mechanical ventilation and mechanical ventilation time, use of prokinetics, use of sedation drugs, use of vasoactive drugs and use of antibiotics were predictors of enteral nutrition feeding intolerance in critically ill patients, among which postpyloric feeding (OR=0.46, 95%CI 0.29 to 0.71, P<0.01) was a protective factor. ConclusionAccording to the influencing factors, the medical staff can formulate a targeted enteral nutrition program at the time of admission to the ICU to reduce the occurrence of feeding intolerance. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
Nursing is one of the disciplines that has been influenced and inspired by the evidence-based medical thinking model during early times. In the past 20 years, evidence-based nursing has developed rapidly and vigorously in the field of international nursing and has become an inevitable trend of future nursing practice. Evidence-based nursing education, research and practice have been simultaneously promoted, and construction of the platform has gradually improved, forming a systematic evidence-based nursing science system and enriching the connotation of evidence-based science.
Objective To investigate the current status of randomized controlled trials (RCTs) and clinical controlled trials (CCTs) on pressure sore in China. Methods We searched Chinese Journal of Nursing, Chinese Journal of Practical Nursing and Journal of Nurses Training in CNKI and VIP (January 2000 to December 2005) for Chinese articles on pressure sore, using "pressure sore", "bed sore", "nursing", "treatment", "prevention", "evaluation" and "management" as search terms. The retrieved articles were summarized. Results We identified 16 reports (10 RCTs and 6 CCTs). The studies were judged to be of low quality.There was one study on the evaluation, two on the prevention, and 13 on the treatment of pressure sores. Conclusion The current studies on pressure sore in China are focusing on treatment. Randomized controlled trials of large sample size of pressure sore are needed to improve nursing quality.
Objective To formulate an evidence-based nursing methods for a patient with grade III handfoot syndrome induced by capecitabine. Methods Based on the cl inical questions, we searched The Cochrane Library (Issue 1, 2008), ACP Journal Club (1991 to January 2008), MEDLINE (1996 to 2008) and CBMdisc (1995 to 2008). The retrieved studies were further critically appraised. Results There were two effective measures in patients with grade III hand-foot syndrome induced by capecitabine: ① Treatment interruption or dose reduction with supportive measures to reduce pain and discomfort and prevent secondary infection. ② Using Traditional Chinese Medicine and no need of treatment interruption or dose reduction. With patients preference, Treatment interruption and supportive measures were administered to the patient. After two weeks, the patient had a complete response. Conclusions To patients with grade III hand-foot syndrome induced by capecitabine, treatment interruption and supportive measures are effective nursing methods.
Enteral nutrition can improve patient’s nutritional status, reduce the incidence of complications, and promote the patient’s rehabilitation. For patients with stroke, enteral nutrition is the first choice for nutritional support. Nurses not only participate but also play important roles in the whole process of nutrition management in stroke. Therefore, standardizing the nursing practice in enteral nutrition and developing nursing guideline in line with Chinese clinical practice is of great significance. In the guideline, 18 key clinical questions had been established via the Delphi method, and for each question, detailed recommendations had been constructed. It is expected to provide clinical standards for enteral nutrition in patients with stroke, and to improve the nutritional management and disease prognosis of stroke patients.
Objective To explore how to integrate the various sources of information in designing an evidence-based nursing care plan for preventing gastrointestinal hemorrhage (GIH) after pancreaticoduodenectomy (PD). Method Papers and references about prevention of GIH after PD were searched between September and October 2015, and an evidence-based nursing care plan was drawn up and implemented from November 2015 to January 2016. Results A total of 79 papers were found and of which 17 were aviliable. Thirty-nine patients were cared on the basis of the effective project, of whom one was dignosed with GIH on the 3rd postoperative day and the rate of post-PD hemorrhage was 2.6%. All patients were diacharged on the 6th or 7th postoperative day. Conclusion Exploring evidences under the guidance of scientific method and applying them to clinical nursing can prevent post-PD hemorrhage and improve life quality of patients.
Objective To investigate the effect of nursing practice on the treatment compliance in schizophrenic inpatients.Methods A total of 196 inpatients with schizophrenia met the inclusion and exclusion criteria were randomly divided into two groups: the rountine nursing group (n=96) and the trial group (n=100). The trial group followed the paths of evidence-based nursing by confirming the affected facts of compliance, collecting the evidence, evaluating the evidence and incorporating this into nursing practice. The change of compliance was evaluated and two groups were scored by NOSIE-30 and BPRS at the beginning and 3 months later, respectively.Results The trial group had a significant improvement (Plt;0.05) on using the chosen treatment and had a lower relapse rate. Conclusions Implementing evidence-based nursing practice has a positive effect on the compliance with treatment of inpatients with schizophrenia.
Psychological distress management can effectively reduce the incidence of psychological distress in female breast cancer patients, improve treatment adherence, and enhance quality of life. Healthcare professionals play a crucial role in the management of psychological distress among female breast cancer patients, and the development of practice guidelines tailored to the Chinese clinical context holds significant importance. This guideline addresses 13 key clinical questions related to the psychological distress management of female breast cancer patients and provides 27 recommendations. It aims to establish clinical standards for the standardized management of psychological distress, with the goal of improving treatment outcomes and quality of life for female breast cancer patients.
目的 为老年股骨颈骨折的患者制定合理的循证护理方案。 方法 在充分了解老年股骨颈患者病情的基础上，根据PICO原则，提出临床问题并转化为易于检索的形式，于2012年5月检索了Cochrane系统评价数据库（CDSR）、Cochrane对照试验注册中心（CCTR）、效果评论摘要数据库（DARE）、Medline、国家指南网（NGC）、PubMed 网站、中国生物医学文献数据库（CBM）以及复旦大学JBI循证护理中心，获取并评价相关的系统评价、随机对照试验以及临床指南。 结果 共检索到3篇系统评价、2篇临床随机对照试验和1篇临床实践指南。根据检索的结果，与患者及家属沟通后，选用Braden量表对患者进行压疮评估；指导患者每2小时翻身；进行腰背肌的锻炼，2～4 h/次，第1天5遍/次，之后逐渐递增为10～20遍/次；指导摄入高能量、高蛋白食物。1周后，患者机体状况良好，顺利接受手术治疗。 结论 采取循证护理的方法可以为患者提供科学、个性化的护理。