对接受血液和骨髓移植的儿童进行肠道营养优化计划:质量改进项目
Jessica D Murphy1, Kenneth R Cooke2, Heather J Symons2
1Johns Hopkins University School of Nursing, 525 North Wolfe Street, Baltimore, MD, USA.
Journal of pediatric nursing
|November 24, 2023
概括
一项针对儿科血液和骨髓移植 (BMT) 患者的新型肠道营养优化计划在提供者中显示出高可行性和接受度. 虽然临床结果没有显著改善,但该计划将文化转向优化营养支持.
科学领域:
- 儿科血液学/瘤学
- 移植医学 移植医学
- 临床营养学 临床营养学
背景情况:
- 营养不良是接受血液和骨髓移植 (BMT) 的儿科患者发病率和死亡率的重要风险因素.
- 优化肠道营养支持是改善这一弱势群体临床结果的潜在策略.
研究的目的:
- 评估一项旨在优化儿科 BMT 患者肠道营养支持的新型计划.
- 评估这项营养优化计划在临床提供者中的可行性和接受度.
主要方法:
- 一个质量改进项目,采用干预前后设计和干预后调查.
- 对接受干预的0-18岁患者的生物识别指标,并发症和移植后里程碑的评估.
- 使用曼-惠特尼U,费舍尔精确和奇平方测试进行统计分析;通过调查收集供应商反.
主要成果:
- 在体重减轻,营养不良率,移植与宿主疾病发生率,移植时间,感染率或组之间的停留时间方面没有观察到统计学上显著的差异.
- 该干预表明了高可行性和接受度,在45名参与提供商中,有88.9%的参与者同意或强烈同意.
- 干预后注意到鼻胃管和胃口管的利用率增加.
结论:
- 新的肠道营养优化计划是高度可行的,并被临床提供者接受,促进了向优先考虑肠道营养的文化转变.
- 尽管接受度很高,但该研究受限于小样本规模,排除了关于临床意义的最终结论.
- 需要进一步的研究来阐明这种营养支持计划在儿科BMT的临床影响.
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