老年住院患者误吸/窒息风险评估及分级饮食护理干预
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摘要
目的分析老年人误吸/窒息的发生原因,探讨误吸/窒息危险因素评估表在老年住院患者误吸预防护理中的应用效果。方法回顾分析2017年1月至2018年7月镇江市中西医结合医院老年科92例住院患者临床资料。2017年1月至2017年9月入院的46例患者采用常规入院护理评估表筛选出高风险患者,以此落实误吸防范护理常规,为对照组;2017年10月至2018年7月入院的46例患者采用误吸/窒息危险因素评估表筛选出高风险患者(≥6分),在误吸防范护理常规基础上,实施书面告知并签署风险知情书,并按照风险程度落实误吸分级饮食护理措施等,为观察组。比较两组患者住院期间误吸等并发症的发生率。结果观察组筛选出高风险患者15例,对照组筛选出高风险患者6例;观察组通过分级饮食干预等措施,患者误吸等发生率15.2%,明显低于对照组的41.3%,差异有统计学意义(P<0.05)。结论对老年人应用误吸/窒息评估表能准确筛选出高风险患者,便于全面落实分级饮食护理干预,有效降低误吸等并发症发生率,确保老年住院患者的安全。
Objective To explore the causes of mis-aspiration/asphyxia in the elderly and the effects of the evaluation table of risk factors of mis-aspiration/asphyxia on the preventive nursing care of elderly inpatients.Methods The clinical data of 92 inpatients in Geriatric Department of Zhenjiang Integrated Chinese and Western Medicine Hospital from January 2017 to July 2018 were retrospectively analyzed. Forty-six patients from January to September 2017 were seleted by routine evaluation forms of nursing(control group) who were treated with routine nursing of aspiration. In the observation group, forty-six patients admitted to hospital from October 2017 to July 2018 were evaluated by the risk factors assessment form for high-risk(≥6 points). On the basis of routine nursing care, the patients in observation group receiving nursing intervention.The incidence of complications such as mis-aspiration during hospitalization between the two groups were compared.Results Fifteen patients with high-risk were selected in the observation group and 6 in the control group. In the observation group, the incidence of accidental aspiration was 15.2%, which was significantly lower than that(41.3%)in the control group(P<0.05). Conclusions The application of mistreatment asphyxia assessment form for the elderly can accurately sort out the patients with high-risk, facilitate the comprehensive implementation of the nursing intervention of graded diet and reduce the incidence of complications such as accidental aspiration effectively, which ensures the safety of the elderly inpatients.
Objective To explore the causes of mis-aspiration/asphyxia in the elderly and the effects of the evaluation table of risk factors of mis-aspiration/asphyxia on the preventive nursing care of elderly inpatients.Methods The clinical data of 92 inpatients in Geriatric Department of Zhenjiang Integrated Chinese and Western Medicine Hospital from January 2017 to July 2018 were retrospectively analyzed. Forty-six patients from January to September 2017 were seleted by routine evaluation forms of nursing(control group) who were treated with routine nursing of aspiration. In the observation group, forty-six patients admitted to hospital from October 2017 to July 2018 were evaluated by the risk factors assessment form for high-risk(≥6 points). On the basis of routine nursing care, the patients in observation group receiving nursing intervention.The incidence of complications such as mis-aspiration during hospitalization between the two groups were compared.Results Fifteen patients with high-risk were selected in the observation group and 6 in the control group. In the observation group, the incidence of accidental aspiration was 15.2%, which was significantly lower than that(41.3%)in the control group(P<0.05). Conclusions The application of mistreatment asphyxia assessment form for the elderly can accurately sort out the patients with high-risk, facilitate the comprehensive implementation of the nursing intervention of graded diet and reduce the incidence of complications such as accidental aspiration effectively, which ensures the safety of the elderly inpatients.
引文
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[2] Sura L,Madhavan A,Carnaby G,et al. Dysphagia in the elderly:management and nutritional considerations[J]. Clin Interv Aging,2012,7:287-298.
[3]孙丽凯,陈俊春.误吸风险评估与饮食分级护理预防高龄患者误吸[J].护理学杂志,2015,30(7):38-41.
[4]罗雪梅.头颈部疾病相关吞咽功能障碍的检查方法比较[J].中国临床医学,2012,19(3):306-307.
[5]李六亿,贾会学.《病区医院感染管理规范》释义[J].中华医院感染学杂志,2017,27(15):3366-3376.
[6]孙丽凯,周雁琼,陈俊春.基于吞咽功能评估的老年病人误吸风险分级护理实践[J].护理研究,2015,4(29):1336-1338.
[7]刘文琴,丁优娜,戎燕.饮食风险管理预防老年患者噎食的效果[J].解放军护理杂志,2010,27(8A):1177-1192.