From best evidence to best practice: enteral nutrition from continuous nasal feeding in stroke patients

Abstract

Background: Best evidence regarding enteral nutrition from continuous nasal feeding in stroke patients is limited. The aim of this study was to explore the best evidence of continuous nasal feeding in stroke patients and translate the evidence into clinical practice. Methods: This study utilized the standard procedures of the Joanna Briggs Institute (JBI) evidence-based nursing centers’ clinical evidence-practice application system. The baseline assessment of stroke patients in the neurology ward was conducted. A pre- and post-implementation audit approach was used in this study and adopted the Getting Research into Practice program. We analyzed the compliance of nurses with best practice and its impact on patients’ gastrointestinal function and complications, aspiration, aspiration pneumonia, nurses’ daily workload of nasal feeding, and the length of hospitalization before and after implementing the evidence-based strategies. Results: After application of the evidence-based strategies, nurses’ compliance with best practice was improved. The incidence of patients’ gastrointestinal complications including vomit (χ2=5.195, P=0.023), palirrhea (χ2=4.216, P=0.039), diarrhea (χ2=4.514, P=0.042), constipation (χ2=5.535, P=0.035) and gastric retention (χ2=4.541, P=0.042) decreased significantly after the application of the best evidence. The working time of nurses undergoing nasal feeding decreased from 23.71±3.22 min to 7.73±1.14 min (P=0.000) and the length of patient’s hospitalization decreased from 35.63±4.45 days to 35.00±3.70 days (P=0.534). The rate of aspiration, aspiration pneumonia did not show a significant difference after implementation of the evidence-based strategies. Conclusion: The results revealed that the evidence-based practice of continuous nasal feeding in stroke patients is an effective method to improve nursing quality and reduce gastrointestinal complications, which was worthy of clinical application.