口服药物经鼻饲给药规范化管理的建立及其临床应用

Establishment and clinical application of standardized management for oral drug administration through nasal feeding

目的建立口服药物经鼻饲给药管理规范,观察其临床实施效果。方法参考国内外权威书籍以及药物说明书,并搜索国内外相关参考文献评估鼻饲给药情况,确定临床在鼻饲给药中的不合理因素。利用相关关键词检索数据库,确定规范相关的参考文献,筛选口服药物经鼻饲给药患者的规范化管理的最佳证据。采用GRADE分级方法,对证据进行分级,综合证据形成鼻饲给药管理规范,并开展循证实践。比较管理规范实施前后医护人员、药师的鼻饲给药认知率、整体答题正确率、用药合理性结果、不良事件情况。结果相较于口服药物经鼻饲给药管理规范实施前,口服药物经鼻饲给药管理规范建立并实施后,医护人员、药师对鼻饲给药认知率、整体答题正确率均升高,鼻饲给药不合理情况减少,鼻饲给药不良事件减少,实施前后组间比较差异均有统计学意义(P<0.05)。结论口服药物经鼻饲给药管理规范的建立对提高医护药人员对鼻饲给药的认知度、减少鼻饲给药不合理情况和不良事件发生均有积极作用。

Objective To establish a standardized management system for oral drug administration through nasal feeding and observe its clinical implementation effect.Methods Authoritative books and drug instructions at home and abroad were consulted,and relevant literature at home and abroad was searched to evaluate the situation of nasal feeding administration,so as to determine the unreasonable factors in clinical nasal feeding administration.Relevant keywords were used to search in the databases,in order to determine the standardized literature and screen the best evidence for the standardized management of patients with intranasal administration of oral drugs.The GRADE grading method was used,the evidence was graded,the comprehensive evidence formed the nasal feeding administration management standard,and evidence-based practice was carried out.The recognition rates of nasal feeding,overall correct answer rates,rational results of medication and adverse events of medical staff and pharmacists before and after the implementation of management standards were compared.Results Compared to before the implementation of the management standard for oral drug administration through nasal feeding,after the establishment and implementation of the management standard for oral drug administration through nasal feeding,the awareness rate and overall accuracy rate of nasal feeding among medical staff and pharmacists increased,the unreasonable situations of nasal feeding administration decreased,the adverse events of nasal feeding administration decreased,and there were statistical significant differences between groups before and after implementation(P<0.05).Conclusion The establishment of standardized management for oral drug administration through nasal feeding has a positive effect on improving the awareness of medical staff towards nasal feeding,reducing the occurrence of unreasonable nasal feeding and adverse events.