脑卒中相关性肺炎护理管理的最佳证据总结

Summary of the best evidence for nursing management of stroke-associated pneumonia

目的检索、遴选并分析脑卒中相关性肺炎护理管理的相关证据,总结形成最佳证据。方法系统检索BMJ最佳临床实践、Up to date、美国心脏协会/美国卒中学会、中国卒中学会、欧洲卒中组织、澳大利亚国家卒中基金会、中国临床指南文库、澳大利亚循证卫生保健中心证据库、Cochrane图书馆、荷兰医学文摘数据库、PubMed数据库、中国知网、万方数据库、维普数据库和中国生物医学文献数据库有关脑卒中相关性肺炎护理管理的所有证据,包括最佳实践建议、临床指南、专家共识、证据总结、系统评价、随机对照试验,两名研究者严格保持独立性和客观性对纳入的文献进行质量评价和资料提取,并对符合质量标准的文献进行证据的总结和归纳,研究小组承担监督者和解决争议的任务。检索时间从建库至2021年8月6日。结果共纳入13篇文献,包括1篇最佳实践建议、4篇临床指南、3篇专家共识、2篇证据总结、2篇系统评价、1篇随机对照试验,形成了25条最佳证据。包括危险因素评估与管理、营养支持与喂养管理、误吸预防与管理、药物管理、中西医结合管理、康复训练管理与护理计划管理模式6个方面。结论临床护士应根据所在医疗机构和患者个体情况,结合循证证据,给予脑卒中相关性肺炎患者早期预防和管理,以科学的护理方法和学科协作的方式解决脑卒中相关性肺炎护理管理问题。

Objective To search,select and analyze the relevant evidence of nursing management of stroke-associated pneumonia(SAP),summarize and form the best evidence.Methods Systematic search for BMJ Best Clinical Practices,Up to date,American Heart Association/American Stroke Association,Chinese Stroke Association,European Stroke Organization,Australia National Stroke Foundation,Chinese Clinical Guide Library,Australian evidence-based Health Care Center(Joanna Briggs Institute,JBI)evidence Summary Database(Ovid port),Cochrane Library,Netherlands Medical Abstracts Database(Embase),PubMed Database,Chinese National knowledge Infrastructure Database,Wanfang Database,All evidence from VIP database and Chinese biomedical literature database on nursing management of stroke-associated pneumonia.It included clinical decision-making,best practice recommendations,clinical guidelines,expert consensus,evidence summary,systematic review,randomized controlled trials,quasi-experimental studies,cohort studies and original literature.Two researchers strictly maintained independence and objectivity to evaluate and extracted the quality of the included literature and summarized the evidence of the literature that met the quality standards,and the research group assumed the task of supervising and resolving disputes.The retrieval time was from the establishment of the database to 6th August 2021.Results A total of 13 articles were included,including 1 best practice recommendation,4 clinical guidelines,3 expert consensus,2 evidence summary,2 systematic review and 1 randomized controlled trial.Finally,25 best evidences were formed,including six aspects:risk factor assessment and management,nutritional support and feeding management,aspiration prevention and management,medication management,integrated traditional Chinese and western medicine management and nursing plan.Conclusion Nurses should give early prevention and management to stroke-associated peumonia(SAP)patients according to the medical institution and individual situation of patients,combined with evidence-based evidence,and solve the problems of SAP nursing management of stroke patients with scientific nursing methods and disciplinary cooperation.