以质量求发展,以服务铸品牌

Journal of Nursing ›› 2021, Vol. 28 ›› Issue (19): 33-38.doi: 10.16460/j.issn1008-9969.2021.19.033

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Evidence-based Practice on Nutrition Screening Evaluation and Management for Inpatients with Chronic Liver Disease

LIU Shan-shan1a, WANG Ying1b, JIA Shou-mei2, DENG Rong1b, JIANG Yan1a, CHEN Fang1b, LUO Yun-ting1b   

  1. 1a. Evidence-based Nursing Center; 1b.Center of Infectious Diseases, West China School of Nursing/West China Hospital, Sichuan University,Chengdu 610041, China;
    2. School of Nursing, Fudan University, Shanghai 200032, China
  • Received:2021-06-17 Online:2021-10-10 Published:2021-11-10

Abstract: Objective To formulate the best evidence for the screening, assessment and management of malnutrition risk in inpatients with chronic liver diseases and apply it to clinical practice so as to standardize the strategy of screening, assessment and management of malnutrition and improve the nutritional level of patients. Methods With JBI's clinical evidence practice application model, after localizing the best evidence, the review indexes for nutritional screening, evaluation and management of patients with chronic liver disease were formulated, and the clinical practice was continuously guided and standardized through training and assessment. The nutritional level of patients, knowledge, attitude and practice (KAP) of the patients and the completion of the Quality Review Index before and after the implementation of the best evidence were compared. Results After the application of the evidence, the incidence of malnutrition in the intervention group was lower than that in the control group, and the ALB level was higher than that in the control group(P<0.05).KAP of the patients was improved (P<0.05)and the performance of the 6 indexes in the Quality Review Index was better(P<0.05). Conclusion Through the application of the best evidence in the screening, assessment and management of nutritional problems of inpatients with chronic liver disease, the nutritional level and the quality of clinical medical care were improved.

Key words: evidence-based practice, chronic liver disease, nutrition management

CLC Number: 

  • R473.51
[1] Yang CQ, Shu L, Wang S,et al.Dietary Patterns Modulate the Risk of Non-alcoholic Fatty Liver Disease in Chinese Adults[J].Nutrients,2015,7(6):4778-4791.DOI:10.3390/nu7064778.
[2] 北京医学会, 肠外肠内营养学会专业委员会. 慢性肝病患者肠外肠内营养支持与膳食干预专家共识[J]. 中华肝胆外科杂志, 2017, 23(2):73-81.DOI:10.3760/cma.j.issn.1007-8118.2017.02.001.
[3] 施万英,陈会杰,张焱,等. 200例肝硬化住院患者营养状况评估[J]. 中国慢性病预防与控制, 2017, 25(4):270-272. DOI:10.16386/j.cjpccd.issn.1004-6194.2017.04.009.
[4] Lindqvist C, Slinde F, Majeed A, et al.Nutrition Impact Symptoms Are Related to Malnutrition and Quality of Life-a Cross-sectional Study of Patients with Chronic Liver Disease[J]. Clin Nutr,2020,39(6):1840-1848. DOI:10.1016/j.clnu.2019.07.024.
[5] 詹斯·康卓普, 雷米·梅耶, 顾良军,等. 营养风险筛查2002改善临床结局[J]. 中华临床营养杂志, 2013, 21(3):133-139.DOI:10.3760/cma.j.issn.1674-635X.2013.03.001.
[6] 詹昱新,杨中善,李素云,等. 基于循证构建住院患者肠内营养护理质量评价指标体系[J]. 护理学报, 2019, 26(10):31-36. DOI:10.16460/j.issn1008-9969.2019.10.026.
[7] Plauth M, Bernal W, Dasarathy S, et al.ESPEN Guideline on Clinical Nutrition in Liver Disease[J]. Clin Nutr,2019,38(2):485-521. DOI:10.1016/j.clnu.2018.12.022.
[8] European Association for the Study of the Liver.EASL Clinical Practice Guidelines on Nutrition in Chronic Liver Disease[J]. [J] Hepatol. 2019,70(1):172-193. DOI:10.1016/j.jhep.2018.06.024.
[9] 中华医学会肝病学分会. 终末期肝病临床营养指南[J]. 临床肝胆病杂志, 2019, 35(6):1222-1230.DOI:10.3760/cma.j.issn.1007-3418.2019.05.003.
[10] 卫茂玲,刘鸣. 中国临床指南循证制定的方法学现状分析[J]. 中国循证医学杂志,2013,13(8):927-932.DOI:10.7507/1672-2531.20130162.
[11] 朱政,胡雁,邢唯杰,等.不同类型循证问题的构成[J].护士进修杂志,2017,32(21):1991-1994.DOI:10.16821/j.cnki.hsjx.2017.21.025.
[12] Brouwers MC, Kho ME, Browman GP, et al.Development of the AGREE II, Part 2: Assessment of Validity of Items and Tools to Support Application[J]. CMAJ. 2010,182(10):E472-478. DOI:10.1503/cmaj.091716.
[13] 周英凤,王强,胡雁,等. 中国护理临床实践指南质量评价标准的构建[J]. 中国循证医学杂志, 2018, 18(9):990-994.DOI:10.7507/1672-2531.201804048.
[14] 胡雁,周英凤,朱政,等. 通过循证护理实践促进护理知识转化[J].护士进修杂志,2015,30(11):5-7.DOI:10.16821/j.cnki.hsjx.2015.11.001.
[15] 高飞,张卫青,梁首勤,等.血清白蛋白、前白蛋白和转铁蛋白在评价慢性肝衰竭患者营养支持中的应用[J].实用医学杂志,2017, 33(4):603-605.DOI:10.3969/j.issn.1006-5725.2017.04.027
[16] 李静. 肝硬化患者营养状况及KAP调查分析[D].太原:山西医科大学,2014. DOI:10.7666/d.Y2660510.
[17] 刘松涛,孟庆华. 2018年我国肝病营养事业年度回顾[J]. 中华医学信息导报, 2019, 34(4):19-20.DOI:10.3969/j.issn.1000-8039.2019.04.014.
[18] 苏庆东,李壮江,谭庆,等.肝移植患者术后早期肠内营养及护理研究进展[J].护理学报,2010,17(16):8-10.DOI:10.16460/j.issn1008-9969.2010.16.005.
[19] 周英凤,胡雁,邢唯杰,等.证据转化与临床应用培训项目的设计与实施[J]. 护理学杂志, 2018, 33(12):59-62.DOI:10.3870/j.issn.1001-4152.2018.12.059.
[20] 周英凤,胡雁,顾莺,等.促进基于证据的最佳实践持续改进临床质量[J].护理研究, 2016,30(35):4432-4434.DOI:10.3969/j.issn.1009-6493.2016.35.025.
[21] 周英凤,胡雁,邢唯杰,等.推动基于证据的临床审查,促进临床质量持续改进[J]. 中国循证医学杂志, 2020,20(6):621-627.DOI:10.7507/1672-2531.202001003.
[22] 杨圆圆,王爱敏,王向阳,等.住院骨折老年患者认知功能与营养状况的相关性研究[J].护理学报,2015,22(21):34-37.DOI:10.16460/j.issn1008-9969.2015.21.034.
[23] 刘芳,魏娜,孙蕊.肠内营养循证护理培训实施效果分析[J]. 中国护理管理,2012,12(5):74-77.DOI:10.3969/j.issn.1672-1756.2012.05.023.
[24] 米元元,沈月,郝彬,等.ICU患者肠内营养支持并发腹泻的循证护理实践[J].中华护理杂志, 2017, 52(11):1291-1298.DOI:10.3761/j.issn.0254-1769.2017.11.002.
[25] 赵诗雨,晏蓉,喻姣花,等. 基于循证构建肠内营养护理质量敏感指标体系[J]. 中华护理杂志, 2019,54(3):344-349.DOI:10.3761/j.issn.0254-1769.2019.03.004.
[26] 章梅云,冯志仙,邵乐文,等. 循证护理团队培训方案的制订及应用效果评价[J]. 中华护理杂志, 2015,50(4):66-69.DOI:10.3761/j.issn.0254-1769.2015.04.015.
[27] Shah S,Callaby H,Hoey S,et al.PTH-214 an Audit Reviewing the Impact of a Nutrition Multi-disciplinary Team on Wastage of Adult Parenteral Nutrition Bags[J]. Gut, 2015, 64(Suppl 1): A504. DOI:10.1136/gutjnl-2015-309861.1102.
[28] 卞薇,Kim B,田旭,等.Johns Hopkins循证护理实践模式的研究进展[J].护理学报, 2017,24(7):26-29.DOI:10.16460/j.issn1008-9969.2017.07.026.
[29] 张煜,张春艳,金玉,等.内科危重症患者深静脉血栓预防审查指标的制定及障碍因素分析[J].护理学报,2020,27(4):37-41. DOI:10.16460/j.issn1008-9969.2020.04.037.
[30] 陈名桂,侯春怡,王芳芳,等.预防ICU患者获得性衰弱最佳早期活动策略的循证护理实践[J].护理学报,2019,26(23):45-49.DOI:10.16460/j.issn1008-9969.2019.23.045.
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