老年髋部骨折患者围术期“2P-3R”营养管理模式构建

Construction of Perioperative "2P-3R" Nutritional Management Mode in Elderly Patients with Hip Fracture

目的构建老年髋部骨折患者围术期营养管理模式,促进患者早手术、早下地、早康复。方法针对老年髋部骨折患者营养管理现状,采用课题研究型品管圈活动进行改进。经过科学循证、专家指导等,从术前、术后及家庭三个环节,骨科、营养科、家庭三个维度,人员、制度、材料设备、方法、信息五个方面,制定三大对策群组并予以实施,包括组建营养支持团队、构建营养管理策略、搭建多维信息交互平台等。结果老年髋部骨折患者首次下地时间缩短为26.7 h,平均住院日缩短为5.6 d,实现了早手术、早下地、早康复的目标。结论对老年髋部骨折患者实施个性化、全流程的序贯性营养干预具有重要意义。后续还需开展大样本多中心研究以进一步验证成效,数据自动采集与智能反馈也是今后研究重点。

Objective To construct the perioperative nutrition management model for elderly patients with hip fracture,and promote the early operation,early going to ground and early recovery.Methods According to the current situation of nutrition management in elderly patients with hip fracture,research-oriented quality control circle activities were used to improve it.Through scientific evidence-based,expert guidance,etc.,from the preoperative,postoperative and family three links,the three dimensions from Orthopedic Department,Nutrition Department,and family,from five aspects of personnel,system,materials and equipment,methods,and information,three countermeasure groups were established and implemented,including setting up nutrition support team,building nutrition management strategy,and building multi-dimensional information interaction platform.Results The first time to go to ground for the elderly patients with hip fracture was shortened to 26.7 h,and the average hospital stay was shortened to 5.6 d,realizing the goal of early operation,early going to ground,and early recovery.Conclusion It is of great significance to implement individualized,whole-stream sequential nutrition intervention for elderly patients with hip fracture.Multi-center studies with large samples are needed to further verify the effectiveness,and automatic data collection and intelligent feedback will also be the focus of future research.