Enhancing Critical Thinking Competency and Nursing Quality in Critically Ill Patient Care: A Quasi-Experimental Study of an Evidence-Based Nutritional Management Protocol
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 84
- 试验地点
- 1
- 主要终点
- Improvement in Junior Nurses' Specialized Critical Thinking Competency
研究概览
简要总结
The EBN-based nutritional management protocol effectively enhances junior nurses' specialized critical thinking competency and improves patient nutritional outcomes and satisfaction, demonstrating its potential to optimize critical care quality. However, further validation through multicenter studies with larger cohorts, extended follow-up periods, and additional outcome measures is warranted.
详细描述
This study aims to develop an evidence-based nursing (EBN)-based nutritional management protocol for critically ill patients and assess its effects on junior nurses' specialized critical thinking competency and nursing quality. A quasi-experimental design was employed, involving 7 junior nurses and 84 critically ill patients in each of the study and control groups. The study group implemented the EBN-based protocol alongside structured training, while the control group adhered to conventional practices. Nursing quality outcomes included assessments of nurses' specialized critical thinking skills, patient nutritional biomarkers (serum albumin, prealbumin), complication rates (aspiration, diarrhea, abdominal distension), and patient satisfaction. Multivariate binary logistic regression analysis identified influencing factors.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Other
- 盲法
- None
入排标准
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •diagnosis of critical illness by attending physicians or higher-qualified specialists according to established critical care diagnostic standards
- •requirement for ICU admission with full access to standardized critical care and medical resources
- •preserved partial gastrointestinal function without severe intestinal obstruction or perforation confirmed by certified nutritionists or senior nurses, enabling potential enteral nutrition (EN) or combined EN-parenteral nutrition (PN) support.
排除标准
- •patients with severe cognitive impairment or psychiatric instability (e.g., advanced dementia, schizophrenia, status epilepticus) impairing capacity to engage in nutritional assessments or adhere to clinical protocols, which would jeopardize data collection reliability
- •terminal-stage conditions (malignancies, renal/hepatic failure) with life expectancy < 7 days or exclusively receiving palliative care, leading to misalignment between their palliative nutritional goals and the study's therapeutic intervention objectives
- •congenital metabolic disorders (e.g., phenylketonuria) or short bowel syndrome requiring specialized nutritional protocols, which were incompatible with conventional critical care nutritional protocols and could compromise the generalizability of study findings
- •pregnancy/lactation due to unique nutritional demands and potential risks to fetal/infant development inherent in the study design, contravening established ethical standards
- •cases involving transfer, voluntary discharge, or withdrawal of consent that compromised data completeness.
研究组 & 干预措施
Conventional group
The conventional group adhered to conventional nutritional management methods and training
干预措施: Conventional group (Other)
Evidence-based nursing group
The study group implemented the EBN-based protocol alongside structured training
干预措施: evidence-based nursing group (Other)
结局指标
主要结局
Improvement in Junior Nurses' Specialized Critical Thinking Competency
时间窗: Baseline: Before training (Day 0). Post-intervention: 3 months after protocol implementation.
Change in critical thinking scores measured by the Chinese Critical Thinking Disposition Inventory (CTDI-CV), a 70-item scale evaluating 7 dimensions (truth-seeking, open-mindedness, analyticity, systematicity, self-confidence, inquisitiveness, cognitive maturity) on a 6-point Likert scale. Higher scores indicate superior competency.
次要结局
- Patient Satisfaction(Day 15.)
- Serum Prealbumin Levels(Day 0 and Day 14.)
- Serum Albumin Levels(ICU admission (Day 0) and Day 14.)
研究者
Yuexiang Zhao
Principal Investigator
Taizhou Hospital