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当前位置：临床护理进展 > 2023年 2卷 (2)期

Open Access Article

Journal of Advances in Clinical Nursing. 2023; 2: (2) ; 1-5 ; DOI: 10.12208/j.jacn.20230050.

Application of Donabedian model in reducing the incidence of enteral nutrition related diarrhea after Whipple
Donabedian模型在降低WHIPPLE术后肠内营养相关性腹泻发生率中的应用

作者： 张玲, 舒悦芬, 金凯舟, 唐雯洁 *

复旦大学附属肿瘤医院护理部，复旦大学上海医学院肿瘤学系上海

*通讯作者：唐雯洁,单位：复旦大学附属肿瘤医院护理部，复旦大学上海医学院肿瘤学系上海；

上海市卫生健康委员会科研课题

发布时间: 2023-02-02 总浏览量: 357

PDF 全文下载引用本文万方数据（WANFANG DATA）

摘要

目的探讨在Donabedian模型指导下的三维质量指标能否降低肠内营养相关性腹泻的发生率。方法对上海市某三级甲等肿瘤专科医院胰腺外科WHIPPLE术后肠内营养相关性腹泻进行持续质量改进（CQI），干预前进行常规护理模式下的现况调查，干预措施主要在Donabedian模型指导下，构建相关性腹泻发生率的结构-过程-结果三维指标，观察该方法与常规护理模式对相关性腹泻发生率的影响差异。结果与干预前比较，肠内营养相关性腹泻的发生率（4.67 % VS 29.91 %）明显下降，差异有统计学意义（P<0.05）。干预前后营养风险筛查及动态评估达标率（74.07% VS 97.06 %）、鼻饲操作考核成绩[（94.42+0.32）分VS（96.65+0.41）分]、肠内营养相关知识考核成绩[（87.85+0.57）分VS（95.73+0.35）分]及肠内营养规范率相关指标均明显改善，差异有统计学意义（均P<0.05）。结论 Donabedian模型指导下的CQI，在降低肠内营养相关性腹泻发生率方面效果显著，值得临床推广。

关键词： Donabedian模型；胰十二指肠切除术；肠内营养；相关性腹泻

Abstract

Objective To explore whether the three-dimensional quality index under the guidance of Donabedian model can reduce the incidence of enteral nutrition related diarrhea.
Methods continuous quality improvement (CQI) was carried out for enteral nutrition related diarrhea after Whipple operation in pancreatic surgery of a class III class a cancer hospital in Shanghai. The current situation of enteral nutrition related diarrhea was investigated under the conventional nursing mode before the intervention. The intervention measures were mainly under the guidance of Donabedian model, to construct the three-dimensional index of structure process result of the incidence of related diarrhea, and to observe the difference between this method and the conventional nursing mode on the incidence of related diarrhea.
Results compared with that before intervention, the incidence of enteral nutrition related diarrhea (4.67% vs 29.91%) decreased significantly (P < 0.05). Before and after the intervention, the compliance rate of nutritional risk screening and dynamic assessment (74.07% vs 97.06%), the assessment results of nasal feeding operation [(94.42 + 0.32) vs (96.65 + 0.41)], the assessment results of enteral nutrition related knowledge [(87.85 + 0.57) vs (95.73 + 0.35)] and the relevant indicators of enteral nutrition standard rate were significantly improved (all P < 0.05).
Conclusion CQI of enteral nutrition associated diarrhea under the guidance of Donabedian model is effective in reducing the incidence of diarrhea, which is worthy of clinical promotion.

Key words： Donabedian model; Pancreaticoduodenectomy; Enteral nutrition; Associated diarrhea

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引用本文

张玲, 舒悦芬, 金凯舟, 唐雯洁, Donabedian模型在降低WHIPPLE术后肠内营养相关性腹泻发生率中的应用[J]. 临床护理进展, 2023; 2: (2) : 1-5.

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