| Objective:The purpose of this study is to construct an early enteral nutrition management scheme for patients undergoing non-invasive mechanical ventilation and nasal feeding,evaluate the application effect of the constructed early enteral nutrition management scheme in the nursing process of patients undergoing non-invasive mechanical ventilation and nasal feeding,and provide a basis for clinical nursing personnel to implement scientific early enteral nutrition management.Methods:This study is divided into two parts.The first part:Based on the literature analysis and the theoretical framework of“nutritional care procedures and models”,a preliminary plan for the management of early enteral nutrition for patients undergoing non-invasive mechanical ventilation and nasal feeding was developed;Select 10 medical and nursing personnel from a Class III hospital in Qingdao for respiratory and critical care,conduct a one-on-one structured in-depth interview,and improve the first draft of the plan;The Delphi method was used to conduct two rounds of correspondence with 22 medical and nursing experts.Based on the results of the correspondence,the research group discussed and modified the protocol to form a non-invasive mechanical ventilation and early enteral nutrition management scheme for patients undergoing nasal feeding.The second part:Applying experimental research methods to explore the application effect of the constructed management scheme in early enteral nutrition for patients undergoing non-invasive mechanical ventilation and nasal feeding.A convenient sampling method was used to select 120 nasal feeding patients who received noninvasive mechanical ventilation from January 2022 to December 2022.SPSS 25.0 software was used to group them using random numbers.The study subjects were divided into control group and experimental group.The control group was treated with routine feeding processes for critically ill patients,while the experimental group was treated with noninvasive mechanical ventilation and nasal feeding based on routine feeding processes for critically ill patients.Data on nutritional indicators,blood gas indicators,comfort scores,tolerance scores for enteral nutrition,non-invasive mechanical ventilation time,ICU stay time,and daily average cost of enteral nutrition were collected from two groups of patients after one week of nutritional support.SPSS 25.0 software was used to statistically analyze the data.Results:(1)A total of 41 questionnaires were distributed through two rounds of expert correspondence.The effective recovery rate for the first round was 86.4%,and the effective recovery rate for the second round was 94.7%,both ≥ 70%.Experts were highly motivated;The authority coefficients of the two rounds of expert correspondence teaching are 0.866 and 0.870 respectively,both above 0.70,indicating a high level of authority;The coordination coefficients(W)of the two rounds of expert correspondence were 0.395 and 0.473,respectively,P<0.01,which were statistically significant and applicable.The non-invasive mechanical ventilation nasal feeding patient early enteral nutrition management program constructed in this study includes 7 primary indicators,15 secondary indicators,and 46 tertiary indicators.(2)There was no statistically significant difference in the general data of the two groups of patients before intervention(P>0.05),and there was no statistically significant difference in the baseline data of the two groups of patients before intervention(P>0.05);After one week of intervention,the nutritional index,blood gas index,comfort score,enteral nutrition tolerance score,non-invasive mechanical ventilation time,ICU stay time,and daily average cost of enteral nutrition in the experimental group were better than those in the control group(P<0.05).Conclusions:(1)The constructed non-invasive mechanical ventilation nasal feeding patient early enteral nutrition management plan has high experts’ enthusiasm,authority,and coordination coefficients,and the constructed management plan is feasible and reliable.(2)The application of non-invasive mechanical ventilation for early enteral nutrition management in patients undergoing nasal feeding has improved their nutritional indicators and ventilation effects,improved their tolerance and comfort of early enteral nutrition,shortened their mechanical ventilation time and ICU stay time,and reduced their daily average nutrition costs,providing theoretical basis for clinical nursing personnel to implement scientific early enteral nutrition. |
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