基于JCI标准对早产儿经口喂养管理的实践与效果观察

The Practice and Effects of Oral Feeding Management Based on JCI

目的:探讨基于美国医疗机构联合委员会国际部(JCI)标准对住院早产儿经口喂养管理的实践与效果。方法:将新生儿重症监护室的391例早产儿随机分为对照组195例和观察组196例,对照组遵医嘱对早产儿进行常规经口喂养;观察组进行JCI标准管理,建立经口喂养管理小组,完善喂养培训,进行全面系统评估、追踪评价并持续质量改进。评估实施JCI管理后医护人员知识掌握情况,比较两组患儿胃肠道反应情况、院内营养实施情况、患儿恢复到出生体重的时间和住院天数。结果:实施JCI管理后医护人员理论培训、操作培训、情景模拟小组讨论评分明显高于实施前(P<0.05);观察组呕吐、腹胀、胃潴留发生例数明显少于对照组(P<0.01);观察组院内营养实施情况明显优于对照组(P<0.05);观察组患儿恢复到出生体重的时间和住院天数明显短于对照组(P<0.05)。结论:实施基于JCI标准下的住院早产儿经口喂养管理,有助于提升医护人员对早产儿营养支持的认知、评估,改善早产儿的营养状况和生长发育,促进我国早产儿健康水平的提升。

Objective：To explore the practice and effects of oral feeding management in premature infants based on the standard of the United States Joint Commission on Medical Institutions （JCI）. Methods：A total of 391 premature infants in the neonatal intensive care unit were randomly divided into the control group with 195 cases and the observation group with 196 cases. The control group was treated with the routine oral feeding in premature infants. The observation group was treated with JCI standard including the establishment of oral feeding management team, the improvement of feeding training, the comprehensive evaluation, the follow-up evaluation and the continuous quality improvement. After the implementation of JCI management, we assessed how much knowledge the medical staff grasped, and gastrointestinal reactions, the status of nutrition implementation in the hospital, the time of premature infants returned to the birth weight length and the length of hospital stay were compared between two groups. Results ： After the implementation of JCI management, the medical staff theoretical training scores, operation training scores, scenario simulation group discussion soeres were significantly higher than those before the implementation（P 〈 0.05 ）, The cases of vomiting, abdominal distention, gastric retention in the observation group were significantly less than those in the control group （ P 〈 0.01 ）. Nutrition implementation in the observation group was obviously better than that of control group （P 〈 0.05 ） ; and the observation group＇s time of returning to birth weight and the hospitalization days were significantly shorter than those in the control group （P 〈 0.05 ）. Conclusion：It is helpful to improve the nutritional status and growth of preterm infants,improve the health level of preterrn infants and enhance the medical workers＇ awareness and assessment of the nutrition support of premature infants by using oral feeding management based on JCI standard.