成人炎症性肠病患者饮食与营养方案的循证实践

Evidence-based Practice of Diet and Nutrition Programs for Adults with Inflammatory Bowel Disease

目的将成人炎症性肠病患者饮食与营养方案的最佳证据应用于临床,并评价其效果。方法本研究依据上海复旦的基于证据的持续质量改进模式图为指导方法,将最佳证据结合研究者所在临床环境,转化成相应的审查指标及审查方法,进行现状审查,分析实施过程中存在的问题及原因并制订解决方法。比较证据实施前后护理人员对成人炎症性肠病饮食与营养的知晓情况及对审查指标的执行情况。结果证据实施前后,临床护士对炎症性肠病饮食与营养的相关知识得分分别为15~34(25.00±6.14)分和30~36(34.61±1.98)分,差异具有统计学意义(t=6.326,P<0.001)。证据应用后有4项审查指标执行情况优于证据应用前(P<0.05)。结论通过制定和应用成人炎症性肠病饮食与营养的最佳证据并将适宜临床情境的证据进行转化并应用,可规范护士依据证据执行的行为,促进护理持续质量改进。

Objective To apply the best evidence for diet and nutrition programs for adults with inflammatory bowel disease and to evaluate its clinical effects.Methods This study was guided by the evidence-based continuous quality improvement model.Combined with the clinical scenario,the best evidence was transformed into the corresponding review indicators and review methods.Solutions were formulated after the review of current situation,and the analysis of the problems and causes existing in the implementation process.Awareness of nurses towards diet and nutrition for adults with inflammatory bowel disease and implementation of audit indicators among nurses were compared before and after the application.Results Before and after the application of the evidence,clinical nurses'score of knowledge on diet and nutrition for adults with inflammatory bowel disease was 15~34(25.00±6.14)and 30~36(34.61±1.98)respectively,and the difference was statistically significant(t=6.326,P<0.001).After the application of evidence,implementation rate of 4 audit indicators was improved(P<0.05).Conclusion Evidence-based practice of diet and nutrition programs for adults with inflammatory bowel disease can regulate the behaviors of nurses,improve nurses'compliance,and quality of clinical nursing.