基于指南的脑卒中吞咽困难识别与管理的循证实践方案的应用

Implementation of the guideline based clinical practice program for identification and management of dysphagia in stroke patients

目的应用基于指南的脑卒中患者吞咽困难识别与管理的循证实践方案,以营造良好的循证实践文化氛围,提高临床护理水平。方法本研究以Iowa循证实践模式为指导,借鉴由RNAO发布的指南实施工具书中相应的实施策略,逐步将方案应用于试点病房。结果方案实施对患者层面(生活质量、满意度及住院时间)、护士层面(满意度和知识水平)以及各审查标准指标层面均产生了积极影响。结论调适国外卒中吞咽困难识别与管理的高质量的指南,在我国进行本土化应用,可提高临床护理质量,本研究可为今后指南应用方面的研究提供参考。

Objectives To implement the guideline-based clinical practice program for identification and management of dysphagia in stroke patients,and to create a good evidence-based practice culture,and to improve the quality of clinical care.Methods In this study,we use the Iowa model of evidence-based practice as a guide,reference guide issued by RNAO to implement the corresponding implementation strategy tool,and gradually apply the program to the pilot ward.Results The implementation of the program had a positive impact on the patient level(quality of life,satisfaction and hospitalization),the nurse level(satisfaction and knowledge),and the level of eachauditcriteria.Conclusion It is possible to improve the clinical nursing quality by adapting the high quality guidelines for the identification and management of dysphagia in foreign countries and this study can provide reference for the research of future guideline implementation.