| Objective To construct a patient care bundles intervention scheme for the prevention of bacterial pneumonia in acute ischemic stroke-associated pneumonia based on the methodology of evidence-based medicine,and to verify the feasibility and effectiveness of the patient care bundles intervention scheme through clinical empirical research.To clarify the preventive effect of patient care bundles intervention on bacterial pneumonia in acute ischemic stroke-associated pneumonia,to reduce the incidence of bacterial pneumonia in patients with acute ischemic stroke,and to improve the quality of clinical nursing.To provide a feasible nursing intervention plan for the prevention of bacterial pneumonia in acute ischemic stroke-associated pneumonia,and to provide scientific reference and scientific basis for the clinical practice and development of evidence-based nursing.Methods Based on the methodology of evidence-based medicine(EBM),a patient care bundles intervention scheme for the prevention of bacterial pneumonia in acute ischemic stroke-associated pneumonia was established.Under the guidance of the tutor group,an evidence-based nursing practice group was set up,and the head nurse was appointed as the leader of the evidence-based nursing practice group.The nurses in the department of neurology were trained in evidence-based nursing and the quality control was carried out in the process of implementing patient care bundles intervention program for nurses in the department of neurology.Sixty patients with acute ischemic stroke who met the inclusion criteria were studied.The closed opaque envelopes were randomly divided into two groups:experimental group(n=30)and control group(n=30),which were treated with patient care bundles intervention scheme and control group(n=30).The brain CT/MRT and NIHSS scores were used to determine the location and severity of stroke.According to the clinical symptoms,serum PCT,CRP and clinical observation scale were used to determine whether stroke-associated pneumonia occurred or not.The data obtained were analyzed statistically with SPSS 19.0 and SAS9.1.3 software to determine the preventive effect of patient care bundles intervention scheme on bacterial pneumonia in acute ischemic stroke-associated pneumonia.Results1.In this study,a patient care bundles intervention plan for bacterial infection pneumonia in patients with acute ischemic stroke was established,which included 12 literatures,including 3 articles of evidence summary,2 articles of best practice information and 7 articles of guidelines.The patient care bundles intervention programs were as follows:evidence-based team,dysphagia management,eating management,oral management,posture management,exogenous infection management,patient family education and quality control,and 14 items of evidence.2.There was no significant difference in general data distribution between the two groups on the day of admission(P>0.05).3.After intervention,the nutritional risk screening score and serum albumin(ALB)in the experimental group were better than those in the control group,and the difference was statistically significant(P<0.05).4.After intervention,the oral hygiene score of the experimental group was better than that of the control group,and the difference was statistically significant(P<0.05).5.After intervention,the NIHSS score of the experimental group was lower than that of the control group,but there was no significant difference between the two groups(P>0.05).6.After intervention,the drinking water test grade of the test group was higher than that of the control group,and the number of cases of aspiration was less than that of the control group,and the difference was statistically significant(P<0.05).7.After intervention,the number of leukocytes in the experimental group was within the normal range,but there was no significant difference between the experimental group and the control group(P>0.05).The results of the pro-calcitonin(PCT),hypersensitive C-reactive protein(CRPH)in the experimental group were in the normal range.Compared with the control group,the difference was statistically significant(P<0.05).8.After intervention,there were 5 cases of bacterial pneumonia in the experimental group and 13 cases in the control group.The difference between the two groups was statistically significant(P<0.05).The incidence of bacterial pneumonia in the experimental group was significantly higher than that in the control group(13 cases)(P<0.05).Conclusion1.Based on the methodology of evidence-based medicine,a patient care bundles intervention scheme for the prevention of bacterial pneumonia in acute ischemic stroke-associated pneumonia was constructed.The traditional empirical nursing decision-making mode was changed and the scientific nature of clinical nursing decision-making was promoted.Increase the accuracy of nursing dose,improve the effectiveness and safety of nursing practice,so as to improve the clinical outcome of patients with acute ischemic stroke and save medical social health resources.2.The patient care bundles intervention program of bacterial pneumonia in acute ischemic stroke-associated pneumonia can effectively reduce the risk of SAP in AIS patients and correct the malnutrition degree of AIS patients in the early stage.The oral hygiene and swallowing function of patients with AIS were improved in time to promote the rehabilitation effect of patients with acute ischemic stroke.3.TOR-BSST?can screen swallowing disorder of patients with ais in time,and has good clinical applicability.The scope of clinical application is expanded,and its specificity,sensitivity and accuracy are high.Therefore,it is suggested that clinical application should be popularized.4.Through knowledge transformation,we can improve nursing staffundefineds evidence-based consciousness,enhance clinical recognition and application of patient care bundles intervention scheme,shorten the distance between socialization,extemalization and internalization of knowledge,and improve the quality of nursing management.To promote the development of evidence-based nursing. |
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