ABSTRACT
Objective:To develop and apply the optimal evidence-based practice plan for enteral nutrition management in severe acute pancreatitis (SAP) patients.Methods:We combined the best evidence and scenario analysis to form the optimal evidence-based practice plan for enteral nutrition management in patients with severe acute pancreatitis, and integrated the plan into clinical practice. According to the procedure of evidence-based practice of the JBI Evidence-based Center, 18 nurses in the intensive care unit (ICU) were trained, and 30 SAP patients were subjected to a baseline review of the implementation of nutritional support care, with obstacles addressed and analyzed. The nutritional support quality were re-examined in another 30 SAP patients after the current plan was practiced.Results:Compared with the results of the baseline review, after the implementation of this plan, the implementation rate of the reviewed indicators was significantly improved; the ICU nurses showed a significant increase in the knowledge of SAP enteral nutrition (88.9% vs 33.3%, P<0.05. Except for the correct rate of catheter selection (100.0% vs 100.0%), the correct rate of implementation of the other 8 indicators (enteral nutrition timing selection, pre-catheterization evaluation, preparation, patients′ position, nutrition preparation selection, perfusion rate regalation, energy calculation, infusion method) was significantly improved (all P value <0.05). Furthermore, both the tolerance and satisfaction of SAP patients for enteral nutrition were significantly improved (all P value <0.05). Conclusions:The application of the optimal evidence-based practice plan for enteral nutrition management of SAP patients was beneficial to standardize the practice of ICU nurses, improve the quality of clinical care and improve the tolerance and satisfaction of enteral nutrition care of SAP patients.
ABSTRACT
Objective To investigate the pshcyological status and influencing factors of patients with acute pancreatitis. Methods Acute pancreatitis patients admitted in Changhai Affiliated Hospital of Navy Medical University from December 2018 to February 2019 were enrolled, and 120 patients were selected using random number table method. Self-made general questionnaire, self-rating depressing scale, self-rating anxiety scale and coping style questionnaire were used for investigation and patients′ psychological status was evaluated. Results In this survey, 109 questionnaires were collected and eligible for final analysis. The incidence of depression in patients with acute pancreatitis was 44. 0％, and the incidence of anxiety was 20. 2％. Male patients had significantly lower anxiety and depression than women. The levels of anxiety and depression in the 31-50 age group were significantly lower than those in other age groups. The level of anxiety in patients with pancreatitis with children was significantly lower than in patients without children. The coping style of "solving problem" was significantly negatively correlated with depression and anxiety level. The"self-blame" coping style was significantly positively correlated with depression and anxiety level. The"rationalized"coping style was positively correlated with the level of depression. Conclusions The mental health status of patients with acute pancreatitis was not optimistic. Different coping styles were important factors affecting the level of anxiety and depression.