| Poststroke aspiration pneumonia with nasogastric feeding usually occurs in poststroke patients who are unable to eat normally and required the use of nasal feeding to meet the need of the body.During that period,the infection is complication and it is very common for nasal feeding patients.Nasal feeding pneumonia can directly affect the prognosis of patients,which leads to prolonged treatment and economic burden.Nasogastric aspiration pneumonia is determined by a variety of factors.Combined with the comprehensive clinical nursing,the concept of cluster nursing is introduced to reduce the infection rate.Cluster nursing is a new type of nursing mode.Each single intervention is proved to improve the outcome through clinical practice,not a simple intervention combination.ObjectiveIn order to prevent,we combine the high risk factors of aspiration pneumonia.By establishing evidence-based problems and searching a large number of documents in database,the literature was sorted and classified,and the documents were selected to conform to the standard,and the unilateral and effective nursing measures were integrated into cluster nursing scheme.The cluster nursing program is applied into the clinic to explore whether the cluster nursing scheme can reduce the incidence of aspiration pneumonia.The study aims to supply the theoretical and practical evidence for prevention of aspiration pneumonia.Method1.To construct cluster nursing schemeThe nursing program of the cluser is established by PICO format.Search for references that meet the inclusion criteria by searching the database.The quality of the research literature is evaluated according to the result of the evaluation.2.Clinical interventionThis clinical trial period: September 2016 to August 2017.Location: department of neurology of a third grade b hospital.Subjects: cerebral apoplexy patients with nasal feeding tube.Sample size: 50 people in the test group and 50 people in the control group.The patients in the control group were given routine neurology care,while the patients in the experimental group were given the cluster nursing measures on the basis of conventional neurology nursing care.Finally,to evaluate the effect of cluster nursing scheme which was used to prevent aspiration pneumonia.Outcome1.Oral nursing care q6h;Raising the bed head during and after nasal feeding;Using pH test paper to detect the end position of nasal feeding tube;Extending the depth of insertion of nasal feeding tube;Nutrition pump intermittent feeding;Abdominal massage before nasal feeding.That six measures were all included in the cluster nursing scheme.2.The effect of clinical intervention: The incidence of aspiration pneumonia was 12% in the test group,30% in the control group and 4.88 in the chi-square value(P < 0.05).ConclusionOn the basis of strict evidence-based theory,a cluster nursing scheme for preventing aspiration pneumonia was constructed and applied in clinical practice.The cluster nursing program in this trial can effectively reduce the incidence of nasal feeding aspiration pneumonia in stroke patients. |
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