Application of FOCUS-PDCA model in nasointestinal enteral nutrition in severe neurological patients

Abstract

Objective To explore the application of FOCUS-PDCA model in nasointestinal enteral nutrition in severe neurological patients. Methods Patients admitted to the neurological intensive care unit of the hospital were selected as the study subjects. 53 patients admitted from January 2017 to December 2017 were the control group, and 78 patients admitted from January 2018 to December 2018 were the observation group.The control group adopted conventional nasointestinal enteral nutrition support, while the observation group applied FOCUS-PDCA model to find out the weak links of nasointestinal tube placement and nutrition support in clinical nursing for patients with severe neurological diseases, analyze the reasons, formulate rectification measures, formulate standardized procedures and standardize nursing.The time, success rate, incidence of enteral nutrition complications, nutritional index and clinical outcome of the two groups were compared. Results The incidence of complications such as aspiration, diarrhea and reflux in the observation group was lower than that in the control group, and the differences were statistically significant (P<0.05). Serum albumin and hemoglobin in the observation group were significantly higher than those in the control group.The success rate of blind insertion increased from 56.00% in 2017 to 93.30% in 2018.The average length of tube placement decreased from 168 minutes in 2017 to 23 minutes in 2018.There were statistically significant differences between the two groups in terms of ICU stay days and hospitalization costs(P<0.05). Conclusions The application of FOCUS-PDCA model can shorten the time of nasointestinal catheterization, improve the success rate of catheterization, reduce the occurrence of enteral nutrition complications in patients with severe neurological diseases, and facilitate enteral nutrition supply and benign outcome of patients with severe neurological diseases. Key words: FOCUS-PDCA model; Neurological intensive; Nasointestinal tube; Nasojejunal tube feeding (NJF)