Journal of Advances in Clinical Nursing

Objective To explore whether the three-dimensional quality index under the guidance of Donabedian model can reduce the incidence of enteral nutrition related diarrhea. Methods continuous quality improvement (CQI) was carried out for enteral nutrition related diarrhea after Whipple operation in pancreatic surgery of a class III class a cancer hospital in Shanghai. The current situation of enteral nutrition related diarrhea was investigated under the conventional nursing mode before the intervention. The intervention measures were mainly under the guidance of Donabedian model, to construct the three-dimensional index of structure process result of the incidence of related diarrhea, and to observe the difference between this method and the conventional nursing mode on the incidence of related diarrhea. Results compared with that before intervention, the incidence of enteral nutrition related diarrhea (4.67% vs 29.91%) decreased significantly (P < 0.05). Before and after the intervention, the compliance rate of nutritional risk screening and dynamic assessment (74.07% vs 97.06%), the assessment results of nasal feeding operation [(94.42 + 0.32) vs (96.65 + 0.41)], the assessment results of enteral nutrition related knowledge [(87.85 + 0.57) vs (95.73 + 0.35)] and the relevant indicators of enteral nutrition standard rate were significantly improved (all P < 0.05). Conclusion CQI of enteral nutrition associated diarrhea under the guidance of Donabedian model is effective in reducing the incidence of diarrhea, which is worthy of clinical promotion.

Donabedian model; Pancreaticoduodenectomy; Enteral nutrition; Associated diarrhea