Study On Construction The Scheme For Ultrasound-guided Nasointestinal Tube Insertion And Maintenance In Critically Ill Patients

Research Purpose:Through evidence-based nursing method,this study constructed the preliminary scheme for ultrasound-guided nasointestinal tube insertion and maintenance in critically ill patients,and then through the Delphi method to establish the scheme.This scheme can refine the key links and operational essentials of tube insertion process,which helps reduce the operator’s dependence on experience,and aim to standardize clinical catheterization operation,improve the safety of nasointestinal tube insertion,realize continuous improvement of nursing quality,and provide reference for clinical implementation of ultrasound-guided nasointestinal tube insertion and maintenance in critically ill patients.Research Methods:1.Based on evidence-based nursing methods,this study developed a comprehensive retrieval strategy,searched domestic and foreign databases on ultrasound-guided nasointestinal tube placement,and conducted strict quality evaluation,data extraction and evidence grading for the final included literature.The draft scheme was formed after expert group discussion.2.Using the Delphi method,the selection of Zhe Jiang province 21 from experts in the field of medical,nursing,ultrasonic,two rounds of enquiry,and according to the expert feedback for item selection and modification,and using indicators such as expert positive coefficient,coefficient of authority,statistical analysis,the result of the enquiry form under the ultrasound guided nasointestinal tube insertion and maintenance in critically ill patients.Research Results:1.Into 34 articles,including 1 piece of clinical decision making,4 clinical guidelines,3papers to expert consensus,9 randomized controlled trials,17 quasi-randomized controlled trials,preliminary formed the scheme of ultrasound guided nasointestinal tube insertion and maintenance in critically ill patients,It covers four dimensions,including indications of catheterization and safety assessment,preparation before operation,tube insertion process,pipeline maintenance and complication monitoring.2.The recovery rate of the two rounds of expert consultation questionnaire was 100%,and the expert authority coefficients of the two rounds were 0.864 and 0.882 respectively.After the second round of consultation,the importance coefficient of each item was between 0.00-0.11,and the operability coefficient of each item was between 0.04-0.11.Kendal harmony coefficient is between 0.186 and 0.310（p<0.01）.Finally,an ultrasound-guided nasointestinal tube insertion and maintenance scheme in critically ill patients was established,including indications and safety assessment of nasointestinal tube placement,catheterization process,pipeline maintenance and complication monitoring,and including 44 items.Research Conclusion:This study through evidence-based retrieval,fully tap the ultrasound-guided naso-intestinal tube insertion and maintenance and operating essentials of the critical steps,through the Delphi method,formed in clinical practice as the guidance of scheme for ultrasound-guided nasointestinal tube insertion and maintenance.It provides clinical reference for carrying out systematic and professional ultrasound-guided naso-intestinal insertion.