ICU内营养支持专科护士岗位设立及其对重症患者营养管理的效果研究

doi:10.3761/j.issn.1672-9234.2025.06.012

摘要/Abstract

摘要：

目的探讨在ICU内设立的营养支持专科护士岗位对重症患者营养管理的效果。方法在ICU内设立营养支持专科护士岗位，明确其准入条件、考核与绩效标准，并基于高级实践护士核心能力框架确定其工作实践内容。采用便利抽样法，选取2023年8月—9月接受肠内营养的ICU患者作为对照组，2024年5月—6月接受肠内营养的ICU患者作为试验组，对照组接受由责任护士提供的营养管理，试验组接受由专岗营养支持专科护士、责任护士共同提供的营养管理，比较两组喂养并发症发生率、喂养达标时间、血糖水平及ICU住院时长。结果试验组喂养并发症发生率低于对照组（ χ²=13.050，P<0.001），喂养达标时间短于对照组（t=2.823，P=0.005），血糖平均值优于对照组（t=2.995，P=0.003）；两组血糖变异系数（Z=-1.392，P=0.164）、ICU住院时长（t=0.688，P=0.493）比较，差异无统计学意义。结论 ICU内营养支持专科护士岗位的设立和实践能够降低重症患者喂养并发症发生率，缩短其喂养达标时间，并改善其血糖管理，但对患者ICU住院时长并无明显影响。未来应进一步优化专岗营养支持专科护士使用管理制度，强化其在重症患者营养支持中的作用，以提升患者整体护理质量和预后水平。

关键词: 专科护士, 高级实践护士, 营养支持, 重症监护病房, 岗位设立与实践

Abstract:

Objective To explore the effects of establishing a nutrition support specialty nurse position in the intensive care unit（ICU） on the nutritional management of critically ill patients. Methods A nutrition support specialty nurse position was established in the ICU，with clear admission criteria，performance，and assessment standards. The work practice content was determined based on the core competence framework for advanced practice nurses. Using convenience sampling，ICU patients who received enteral nutrition from August 2023 to September 2023 were selected as the control group，and those who received enteral nutrition from May 2024 to June 2024 were selected as the experimental group. The control group received nutritional management provided by the responsible nurses，while the experimental group received nutritional management jointly provided by the specialized position nutrition support specialty nurse and the responsible nurses. The incidence of feeding complications，the time to achieve feeding goals，blood glucose levels，and the length of ICU stay were compared between the two groups. Results The incidence of feeding complications in the experimental group was lower than that in the control group（ χ²=13.050，P<0.001），and the time to achieve feeding goals was shorter（t=2.823，P=0.005）. The blood glucose level in the experimental group was better than that in the control group（t=2.995，P=0.003）. There were no statistically significant differences in the coefficient of variation of blood glucose（Z=-1.392，P=0.164） or the length of ICU stay （t=0.688，P=0.493） between the two groups. Conclusion The establishment and practice of a nutrition support specialty nurse position in the ICU can reduce the incidence of feeding complications in critically ill patients，shorten the time to achieve feeding goals，and improve blood glucose management，but it has no significant impact on the length of ICU stay. In the future，the management model for specialty nurses should be further optimized to strengthen their role in nutritional support for critically ill patients，thereby improving the overall quality of care and prognosis for patients.

Key words: Specialty nurses, Advanced practice nurses, Nutritional support, Intensive care unit, Position establishment and practice

李豪, 徐榆林, 林红振, 任婷, 李春朋, 蒋秋焕, 李黎明, 卫晓静, 景孟娟. ICU内营养支持专科护士岗位设立及其对重症患者营养管理的效果研究[J]. 中华护理教育, 2025, 22(6): 712-717.

LI Hao, XU Yulin, LIN Hongzhen, REN Ting, LI Chunpeng, JIANG Qiuhuan, LI Liming, WEI Xiaojing, JING Mengjuan. Establishment of a nutrition support specialty nurse position in the ICU and its impact on nutritional management of critically ill patients[J]. Chinese Journal of Nursing Education, 2025, 22(6): 712-717.

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