Construction and clinical application of quality evaluation system of enteral nutrition implementation pathway in stroke patients by nasal feeding

Kuang Yongmei; Huang Yi; Ye Maiyun; Wang Juanjuan

doi:10.11850/j.issn.1009-122X.2024.10.011

Abstract：Objective To establish a scientific evaluation system for the quality of enteral nutrition in stroke patients by nasal feeding,and analyze its clinical application value.Methods The quality evaluation system was constructed using the Delphi method.A pre-post case-control study design was employed,with 100 stroke patients randomly sampled using simple random sampling,divided into a control group and an observation group,with 50 patients in each.The control group received traditional enteral nutrition pathway nursing care,while the observation group received care based on the'Quality Evaluation System of Enteral Nutrition Implementation Pathway for Nasogastric Stroke Patients'.The intervention was carried out until the patients were discharged,and they were followed up for 1 month after discharge.Nutritional status,neurological function,life satisfaction levels,and complications were recorded at discharge and 1 month post-discharge for both groups.The response rate for the two rounds of expert questionnaire surveys was 100%.In the first round of the quality evaluation system construction,the expert judgment coefficient,familiarity coefficient,and authority coefficient were 0.845,0.893,and 0.789,respectively;in the second round,these coefficients were 0.866,0.925,and 0.793,respectively.The variation coefficients for the coordination degree of each indicator ranged from 0.100 to 0.213.The Kendalls W coefficients for the two rounds were 0.783 and 0.795,respectively.The quality evaluation system comprised a total of 5 evaluation indicators and a list of caveats.Results The serum prealbumin and serum albumin levels in the observation group were significantly higher than those in the control group at both discharge and 1 month follow-up(P<0.05).The National Institute of Health Stroke Scale(NIHSS)scores in the observation group were lower than those in the control group at both discharge and one-month follow-up,while the Satisfaction with Life Scale(SWLS)scores in the observation group were higher than those in the control group at the same time points(all P<0.05).The total complication rate of the observation group was lower than that of the control group during the intervention period and the follow-up period(P<0.05).Conclusions The application of the quality evaluation system in stroke patients with dysphagia can effectively improve patients'nutritional status,promote neurological recovery,enhance patients'life satisfaction,and reduce the incidence of complications.