影响实施和遵守基于体积的肠道养协议在重症监护环境中的因素:范围审查
Carolyn Hall1, Sophie Page1, Noël Kelly1
1Department of Nutrition & Dietetics, Monash Health, Clayton, Victoria, Australia.
基于体积的养 (VBF) 改善了ICU的肠道营养供应. 成功实施需要领导力,教育和集成的工作流程,尽管遵守情况各不相同.
科学领域:
- 关键护理医学 关键护理医学
- 营养支持营养支持
- 医疗保健实施科学 医疗保健实施科学
背景情况:
- 肠道营养在重症监护室 (ICU) 中至关重要,但分娩往往不足于规定的数量 (约60%).
- 基于体积的养 (VBF) 是一种补偿错过的肠道营养输送的策略.
- 本综述考察了影响成人重症监护机构VBF遵守和实施的因素.
研究的目的:
- 识别在成人重症监护中实现基于体积的养 (VBF) 协议的可能和阻碍因素.
- 评估VBF在重症监护病房 (ICU) 的可接受性和坚持率.
- 为优化在ICU中VBF协议实施的未来战略提供信息.
主要方法:
- 在主要数据库 (MEDLINE,EMBASE,Emcare) 和灰色文献中进行了系统的文献搜索.
- 包括专注于成人ICU患者VBF或追赶养协议的研究.
- 分析了报告障碍,促进因素,可接受性或遵守VBF的研究.
主要成果:
- 包括28项涉及7057名参与者的研究,主要来自美国和加拿大.
- 启用因素包括管理支持,多学科参与,教育和协议集成到工作系统中.
- 障碍包括营养不优先考虑的文化,安全问题,员工流动和不良整合到电子医疗记录中. 坚持的程度差异很大 (32.1%-90%).
结论:
- 成功实施VBF取决于强有力的领导力,员工教育,团队参与,以及无整合到临床工作流程中.
- 虽然VBF对ICU工作人员来说是可以接受的,但持续的坚持需要持续的教育.
- 在ICU中,VBF应该被视为增强营养策略的关键组成部分.
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