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Reducing the incidence of stroke-associated pneumonia: an evidence-based practice

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机构: [1]Department of Neurology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, No.111, Dade Road, Yuexiu District, Guangzhou, China. [2]Nursing department, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, No.111, Dade Road, Yuexiu District, Guangzhou, China. [3]Development Research Center of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, No.111, Dade Road, Yuexiu District, Guangzhou, China.
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关键词: Stroke Pneumonia Evidence-based practice Quality improvement Prevention Patient safety

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Background Pulmonary infection is a frequent complication among stroke patients and adversely affects clinical outcomes, increases the length of hospitalization stay and costs, and aggravates the financial burden of the national medical health system. Early identification and management of high-risk patients are necessary and imperative to reduce the incidence of stroke-associated pneumonia (SAP). Aim The evidence-based practice project evaluated the effectiveness of a standard care bundle intervention in preventing the occurrence of SAP. Methods The project was conducted in a neurology department of a teaching hospital. Given the variation in assessment and management standards, evidence-based practice (EBP) methodology was used to establish a process for quality improvement. A thorough literature search was conducted to identify evidence-based interventions to manage and prevent SAP. Thorough critiques of the literature and synthesis of the evidence were completed. A systematic management flow and care bundle interventions were established. The care bundle included interventions, such as the utilization of tools for SAP risk screening; dysphagia screening and rehabilitation; feeding modification, oral care, airway management, position management, and the nursing techniques of traditional Chinese medicine. Results A significant improvement was observed in preventing SAP in patients in the postimplementation group compared with those in the preimplementation group (14.0% vs. 37.2%, p = 0.025). In addition, significantly lower duration of hospitalization, lower rate of aspiration, and improvements in albumin and oral hygiene were found after the implementation of the care bundle. Conclusions Evidence-based care bundles successfully empower nurses to reduce the incidence of SAP. The management flow of SAP prevention could be promoted to other units of the neurology department in the future. The results of the project reflect positively on the capacity to implement EBP in an acute care setting for stroke. The EBP methodology can be utilized to solve other clinical problems.

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出版当年[2021]版:
大类 | 4 区 医学
小类 | 4 区 临床神经病学
最新[2025]版:
大类 | 3 区 医学
小类 | 4 区 临床神经病学
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出版当年[2020]版:
Q3 CLINICAL NEUROLOGY
最新[2023]版:
Q3 CLINICAL NEUROLOGY

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第一作者机构: [1]Department of Neurology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, No.111, Dade Road, Yuexiu District, Guangzhou, China.
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