| ObjectiveBased on the concept of evidence-based nursing,Delphi method was used to construct a cluster nursing plan for the prevention of gastric retention in patients with ICU,and it was applied to the clinic to evaluate the effect of the cluster nursing program on the prevention of gastric retention in ICU patients,so as to provide a standardized nursing plan for clinical nurses.Methods1.Using the PIPOST model,a cluster group was set up to search the literature,and after screening,inclusion and evaluation,the items related to the prevention of gastric retention were sorted out,discuss the items and formulate a letter questionnaire.Delphi method is used to send two rounds of letter inquiry questionnaires to domain experts,who evaluate the importance and maneuverability of each item,and use statistical methods to analyze the results.At the same time,it satisfies the screening principles of importance assignment mean(CV)<0.25,50%approval rate(Cj)and Kj rate(Kj)≥20%,combined with expert opinions.The final cluster nursing plan was determined after cluster group discussion.2.A total of 72 critically ill patients who received enteral nutrition through nasogastric tube in the intensive care unit of a Grade 3A hospital in Zhengzhou from July 2021 to October 2021 were selected by convenient sampling method.The control group was given routine nursing care.On this basis,the intervention group carried out cluster nursing intervention.The incidence of gastric retention,nutritional status,time to reach the target nutrition and length of stay in ICU were used as evaluation indexes to evaluate the intervention effect.The data were statistically analyzed by IBM SPSS26.0 software,normal distribution test was performed on the data,χ2 test was used for classified variables,and t test was used for continuous variables.P<0.05 is statistically significant.Results1.Finally,a cluster nursing scheme is formed,which includes 3 first-level items,10 second-level items and 22 third-level items.Two rounds of expert letter inquiries showed that the effective recovery rate of the questionnaire was 100%,the judgment basis coefficient Ca was 0.96 and 0.97,the familiarity coefficient Cs was 0.84 and 0.86,and the expert authority degree was 0.9 and 0.92 respectively.After two rounds of inquiry,the coefficients of variation of importance and maneuverability of each item were 0-0.160,0-0.159 and 0.301 and 0.286 respectively.2.Before intervention,there was no significant difference in age,sex,BMI,APACHEII,NRS2002,SOFA,RASS,main diagnosis,mechanical ventilation,sedative use,insulin use,parenteral nutrition use and other clinical data between the two groups,indicating that the two groups of patients were comparable.After intervention,the incidence of gastric retention in the intervention group was significantly lower than that in the control group(P<0.01),and the levels of total protein,albumin and prealbumin in the intervention group were significantly higher than those in the control group(P<0.05).There was no significant difference in hemoglobin level between the two groups(P>0.05).After intervention,the time taken for patients to reach the target feeding dose in the intervention group was compared with that in the control group,and the time of staying in ICU in the intervention group was significantly shorter than that in the control group.ConclusionsIn this study,based on the concept of evidence-based nursing,Delphi expert inquiry method was used to construct a cluster nursing plan for the prevention of gastric retention in patients with ICU.Through clinical application,the prevention of gastric retention in patients with clustered nursing program can effectively reduce the incidence of gastric retention and improve the nutritional status of patients,which has important clinical value. |
PDF Full Text Request