护士为主导的多学科团队协作营养管理模式在神经重症患者中的应用

Nutritional management by a nurse-led multidisciplinary team in neurocritical care patients

摘要:

目的 探讨以护士为主导的多学科团队协作（Multiple Disciplinary Team，MDT）营养管理模式在神经重症患者中的应用效果。方法 选择2017年1月至2018年12月在我院就诊的神经外科重症患者作为研究对象，其中对照组患者39例，给予常规肠内营养支持；研究组患者42例，给予护士主导的MDT营养管理模式，观察两组患者干预效果。结果 研究组NRS20002（Nutritional Risk Screening，NRS 2002）营养风险筛查率高于对照组（P<0.05），肠内营养实施时间低于对照组，早期肠内营养实施率高于对照组，差异均有统计学意义（P<0.05）；干预后研究组白蛋白（Alb）、血红蛋白（Hb）、前白蛋白（PAB）水平均高于对照组，（P<0.05）；两组患者营养支持的并发症及患者家属的满意度比较差异均有统计学意义（P<0.05）。结论 基于护士主导的MDT营养管理模式可规范神经外科重症患者营养实施，改善患者营养状态，减少术后并发症发生率，有利于建立良好护患关系，值得临床推广应用。

Abstract:

Objective To explore the effect of nutritional management by a nurse-led multidisciplinary team (MDT) in neurocritical care patients.Methods We selected critical care patients who were hospitalized in the neurosurgery department of our hospital from January 2017 to December 2018. Thirty-nine cases (control group) were given routine enteral nutrition support, while 42 cases (research group) received nurse-led MDT nutritional management. Intervention effects were evaluated in both groups.Results Compared with the control group, the research group had a significantly higher screening rate for nutritional risk (using Nutritional Risk Screening 2002) (P<0.05), a significantly shorter time to enteral nutrition (P<0.05), and a significantly higher rate of early enteral nutrition (P<0.05). After intervention, the research group had significantly higher levels of albumin, hemoglobin, and prealbumin than the control group (P<0.05). There were also significant differences between the two groups in the complications of enteral nutrition and degree of satisfaction of patients' relatives (P<0.05).Conclusions Nurse-led MDT nutritional management contributes to standardizing the implementation of nutrition in critical care patients in neurosurgery department, improving the nutritional status of patients, reducing the incidence of postoperative complications, and establishing a good nurse-patient relationship, and thus it is worthy of clinical promotion.