| Objective: Analyze the current situation and causes of aspiration in critically ill patients during enteral nutrition;Based on the established enteral nutrition aspiration risk assessment form for critically ill patients,the implementation of hierarchical nursing intervention measures for critically ill patients who implement enteral nutrition,and to evaluate the impact of nursing intervention based on aspiration risk stratification on the outcome of aspiration rate and calorie compliance rate of critically ill patients undergoing enteral nutrition.Methods: This research is divided into two parts: 1.The first part: Select 126 critically ill surgical patients who were admitted to the intensive care unit of the Eastern Theater General Hospital from May 2020 to August 2020 for enteral nutrition.The self-developed enteral nutrition aspiration risk questionnaire for critically ill patients was used to dynamically monitor and record the patient’s current status of aspiration within 7 days from the start of enteral nutrition,and analyze the influencing factors of aspiration and related prognostic indicators.2.The second part: Apply the risk assessment form of enteral nutrition aspiration for critically ill patients constructed by the research group in the early stage of clinical application,and adopt a before and after control study.From May 2020 to August 2020 as the control group,the aspiration risk assessment form is not used for evaluation,and routine clinical nursing measures are adopted;Expectations for nurse training from September 2020 to October 2020;From November 2020 to February 2021,it was the experimental group.The enteral nutrition aspiration risk assessment form for severely ill patients was used to assess the aspiration risk of patients,and the patients were given graded nursing interventions based on the scoring results.Result: 1.Among the 126 critically ill patients undergoing enteral nutrition in the study,96 did not experience aspiration,30 patients experienced aspiration,and the incidence of aspiration was 23.81%.Logistics Regression analysis showed that APACHEⅡ score,awareness status,nutritional risk,and length of nasal feeding tube are the risk factors for aspiration in critically ill surgical patients.2.The experimental group and the control group each enrolled 120 critically ill patients undergoing enteral nutrition.The study showed that 17 patients in the test group had aspiration and 30 patients in the control group.There was a significant difference in the incidence of aspiration between the two groups(P=0.034);On the 7th day,the hot-calorie compliance rate in the experimental group was 40.83% and that in the control group was 28.33%,the difference was statistically significant(P=0.042).The average length of stay in ICU of the experimental group was 19 days,and that of the control group was 30 days,the difference was statistically significant(P<0.001);The average total length of hospital stay in the experimental group was 23 days and that in the control group was 34 days,the difference was statistically significant(P<0.001);The average hospitalization cost of the experimental group was about 193,360 yuan,and the hospitalization cost of the control group was about 299,270 yuan,the difference was statistically significant(P=0.003).Conclusion: 1.The incidence of aspiration during enteral nutrition in severely ill patients is higher,which is related to patient awareness,nutritional risk,APACHE Ⅱ score,and length of nasal feeding tube.The clinical medical staff can closely observe the patients according to the relevant factors affecting the aspiration of the patients.2.Apply the enteral nutrition aspiration risk assessment form for critically ill patients to evaluate the risk of aspiration for patients,and take corresponding hierarchical nursing intervention measures based on the assessment results.It can reduce the incidence of aspiration in critically ill patients who implement enteral nutrition,increase the rate of calorie compliance,shorten the hospital stay of patients,reduce hospitalization costs,and reduce the economic burden of patients. |
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