成人患者经鼻胃管喂养临床实践指南(2023年更新版)

The clinical practice guide for nasogastric tube feeding in adult patients(2023 update version)

目的 对2015年构建的《成人患者经鼻胃管喂养临床实践指南》进行更新。方法 于2022年1月-2023年3月,基于NICE更新流程,通过专家函询和护士访谈确定需要新增和修订的章节,系统检索专业网站和数据库中关于鼻饲护理的最佳证据,3名研究者独立对文献进行资料提取和证据汇总,通过专家函询确定推荐级别;根据CheckUP更新指南报告清单形成指南初稿,通过现场论证和外部评审对指南进行修改及完善,形成指南更新的终稿。结果 与原版指南相比,更新版指南新增了改善胃肠道功能和血糖控制章节,删除了营养配方和鼻饲不良事件的上报章节,重点更新了鼻饲置管前评估、胃管置管、鼻饲喂养等13个章节,指南更新及补充的条目共67条,52条强推荐,15条弱推荐。结论 本研究汇总了目前成人患者鼻饲相关的最新证据,对原有的《成人患者经鼻胃管喂养临床实践指南》进行更新,可进一步为临床鼻饲护理管理提供最佳临床决策,规范鼻饲护理流程。

Objective To update the Clinical Practice Guide for Adult Feeding via Nasogastric Intubation constructed in 2015.Method Based on the NICE update process,expert correspondence and nurse interviews were conducted to identify the chapters that need to be added and revised,and the best evidence on nasal feeding care was systematically searched on professional websites and databases from January 2022 to March 2023.Three researchers independently extracted and summarized the literature,and the recommendation level was determined through expert correspondence,and a preliminary draft of the guidelines was formed based on the CheckUP update guide report list.The guidelines were revised and improved through on-site argumentation and external review to finalize final version of the updated guidelines.Result Compared with the original guidelines,the updated guidelines had added chapters on improving gastrointestinal function and blood sugar control,deleted the chapters of nutritional formulas and adverse events reporting related to nasogastric feeding,and focused on updating 13 chapters on nasogastric feeding pre-evaluation,gastric tube placement,and nasogastric feeding.There were a total of 67 updated and supplemented guidelines,with 52 strong recommendations and 15 weak recommendations.Conclusion This study summarizes the latest evidence related to adult patients'nasal feeding at present,and updates the original Clinical Practice Guide for Adult Patients Feeding through Nasogastric Intubation,which can further provide the best clinical decision for clinical nasal feeding nursing management and standardize the nursing process of nasal feeding.