Nursing Intervention Based On The Pattern Of KTA To Elderly Patients With Bowel Preparation Before Colonoscopy Examination Effect Research

Objective:With gastrointestinal tract disease development,a growing number of endoscopic check,including elderly patients in a certain proportion of endoscopic check the crowd,and increased year by year.Qualified intestinal preparation is an important prerequisite for the smooth progress of colonoscopy.Due to the decline of gastrointestinal physiological function in elderly patients,accompanied by the decline of memory and comprehension,the unqualified rate of intestinal preparation is relatively high,which seriously affects the quality of colonoscopy.This study is based on the KTA model,evaluation guidelines,guidelines recommendation as the basis,to questionnaire survey and qualitative interview results as a supplement,the development of intestinal preparation for elderly patients with nursing intervention measures,and evaluation of the effect.Methods:1.Based on the evidence-based practice model of KTA,relevant guidelines and consensus on intestinal preparation in the past five years were summarized by literature retrieval.The included guidelines were evaluated by the AGREE II guideline evaluation system.2.Convenience sampling method was adopted to select the elderly patients who underwent colonoscopy in a third-grade a hospital in Shanxi Province as the research object,to investigate the intestinal preparation status of middle-aged and elderly patients undergoing clinical colonoscopy and analyze the influencing factors.3.Through qualitative interviews with unqualified subjects and nursing staff,the promotion and hindering factors of evidence application of intestinal preparation before clinical colonoscopy were analyzed.4.Nursing intervention measures in line with intestinal preparation before colonoscopy for elderly patients were formulated through expert meeting method.5.The application effect of the intervention was evaluated by the methods of the nurses' own before and after control study and the subjects' non-contemporaneous controlstudy.Results:1.Through literature search,a total of 4 intestinal preparation related guidelines were included,including 2 for the United States,1 for Europe and 1 for the digestive endoscopy branch of the Chinese medical association.The 4 guidelines were all issued within 5 years with good timeliness.For the evaluation of the guide,AGREE to 0.755 points,relatively authoritative.Contents related to intestinal preparation were extracted,including intestinal preparation education,selection of intestinal detergent,method of taking intestinal detergent,time of intestinal preparation,dietary preparation,auxiliary measures and evaluation of intestinal cleanliness,etc.2.The average age of the 80 subjects was(65.93±5.728),and the average BBPS score was(5.76±1.292),among which 121(67.2%)and 59(32.8%)were qualified in intestinal preparation.The results of univariate analysis showed that the risk factors of unqualified intestinal preparation were daily exercise habits,incomplete use of intestinal detergent,unaccompanied walking during medication,and the last defecation containing fecal residue(P < 0.05).3.Through qualitative interviews with nursing staff and 10 cases of unqualified intestinal preparation subjects,the obstacles to the implementation of evidence were obtained,including: inadequate education and supervision of medical staff;Patients with insufficient understanding,insufficient attention,forgetting,misunderstanding of intestinal preparation,intolerance,lack of professional guidance,etc.4.Through the expert meeting method,based on the guideline recommendations,supplement on the results of questionnaire survey and qualitative interviews,formulated the corresponding clinical nursing measures,including patients nursing staff in the appointment to strengthen the propaganda and education;The color picture and text notice is issued to the examinee for the convenience of the patient's understanding.B.issue client's bowel preparation record card and request client to record.Play the role of family members in the intestinal preparation of patients,gradually promote the implementation of the program,and introduce evidence into clinical practice.5.Non-synchronous intervention control was adopted,and there was no statistically significant difference in general data between the intervention group and the control group(P> 0.05).The patients in the intervention group were superior to the control group in terms of intestinal cleanliness,compliance,occurrence of adverse reactions,and patients' satisfaction with intestinal preparation,with statistically significant differences(P < 0.05).The questionnaire survey and semi-structured observation on the execution of intestinal preparation education were carried out on the nursing staff,which greatly improved the strength of education education.Conclusion:1.This study summarized the best evidence of intestinal preparation in the past five years,including the propaganda and education of intestinal preparation,the choice of intestinal cleanser,the method of taking intestinal cleanser,the time of intestinal preparation,dietary preparation,auxiliary measures and the evaluation of intestinal cleanliness,etc.,in order to provide a reference basis for the intestinal preparation before colonoscopy.2.Based on this study KTA knowledge transformation model in elderly patients with bowel preparation before colonoscopy examination of evidence-based practice research,through comprehensive,survey evidence,identify problems,will be the best evidence for clinical use,evidence analysis using the obstacle factors,formulate the corresponding intervention measures and implementation and evaluation,effectively promoted the transformation of the evidence.3.The elderly patients with intestinal preparation based on the pattern of KTA nursing intervention measures,set up on the basis of the evidence-based,effectively improve the quality of elderly patients with intestinal preparation and feasible.