Study On The Application Of Evidence-based Practice On Patients With Dysphagia After Ischemic Stroke During Recovery

Objective Under the guidance of evidence-based medicine methodology,this study conducted a systematic search of relevant domestic and foreign literature.The theme of these documents was "post-ischemic stroke dysphagia(PISD)in the recovery period",and then passed the literature quality evaluation of evidence-based methodology.This study also used the Delphi method to finally construct a bundles of care for patients who in the recovery period of with PISD.Through clinical intervention research,the effect of the bundles of care was verified.Method1.Based on the method of evidence-based medicine,an evidence-based nursing practice group was established under the guidance of the mentor team to complete the theoretical research of the bundles of care.First,we systematically searched the relevant literature on PISD,and then screened out the latest and best evidences.Finally,we conducted three rounds of Delphi expert consultation method to construct a bundles of care for PISD patients.2.A non-contemporaneous randomized controlled clinical study was used.The location was the rehabilitation department of a tertiary hospital.The time was from October 2019 to September 2020.The subjects of the study were 60 patients who were diagnosed for the first time with dysphagia(WST grade was Ⅲ)after recovery of ischemic stroke.Having been usied a simple random method,the patients were divided into a test group and a control group.The study subjects were intervened for 12 days,in which patients in the experimental group received a bundles of care,and patients in the control group received routine care.researcher have been collected the WST grade,aspiration rate,and brief swallowing rehabilitation assessment results,used them to observation indicators of the improvement rate of swallowing function.In order to evaluate the relationship between rate of aspiration pneumonia(AP)and dysphagia,researcher also collected the results of blood biochemical indicators and physical examination.Finally,the SPSS 20.0 software has been used to perform statistical analysis on the collected data to prove the intervention effect of the bundles of care.Result1.This study conducted a study on the bundles of care in PISD during the recovery period.There were included 20 articles through screening.Including 1 clinical decision,8evidence-based guidelines,2 systematic reviews,and 3 expert consensus guidelines.Totaly,there have been included 24 pieces of evidence in the bundles of care.2.Before the investigator’s intervention,two groups general informationdata of patients were no difference(P>0.05).3.After the investigator intervened,regarding the NIHSS score,the score of the experimental group was lower than that of the control group,and there was a difference between the two groups(P<0.05).4.After the researchers implemented the intervention measures,from the summary of the swallowing rehabilitation evaluation results,the results of the test group were better than those of the control group,and the number of aspiration cases in the test group was less than that of the control group,and the two groups had a difference(P<0.05).5.After the researchers intervened,from the results of lung infection indicators,the results of the test group were better than those of the control group.There was a difference between the two groups(P<0.05).6.After the researcher’s intervention,from the results of the incidence of AP,the incidence of the test group was lower than that of the control group,and there was a difference between the two groups(P<0.05).7.After the researcher’s intervention,from the SWAL-QOL score,the results of the test group were lower than those of the control group,and there was a difference between the two groups(P<0.05).8.After the researcher intervened,from the NRS 2002 scoring results,the scores of the two groups were within the normal range,and there was no difference in the scores of the two groups(P>0.05).Conclusion More optimized than traditional care is evidence-based care(EBC),because the EBC was based on the scientific evidence.Nurses combine clinical experience with patients’ wishes and use them in nursing practice,which increases the feasibility and pertinence of the original scientific nursing practice.This study,which constructed a clustered nursing intervention program,was not only based on evidence-based nursing and Delphi method,but also through clinical practice,which ultimately improved the clinical outcome of patients who was in the recovery period of PISD,promoted the recovery of swallowing function,and improved Improve the quality of clinical care.The use of TOR-BSST? warned patients of aspiration risk and reduced the incidence of AP.