【摘要】 目的 基于COSO-ERM框架下MDT团队对脑卒中患者发生误吸的干预效果研究，为临床提供防止误吸的安全护理的标准。方法 前瞻性选取干预组154例脑卒中鼻饲患者，采用回顾性选取对照组130例脑卒中鼻饲患者。组建MDT团队，进行责任分工，培训专科医护人员。应用COSO-ERM框架有效干预脑卒中患者发生误吸。结果 两组研究对象在鼻饲体位（P<0.05），通气方式和喂养途径（P<0.05），营养液输注方式（P<0.05），营养液输注速度（P<0.05）上，差异有统计学意义。干预组发生12例误吸，误吸发生率为7.79%，对照组发生19例误吸，误吸发生率为14.61%；两组住院时间、住院费用、目标热量达标率（P<0.05）上差异有统计学意义。结论 MDT团队通过对患者实施精准肠内营养护理，有助于提升患者营养达标率，降低误吸率和经济成本。应用COSO-ERM框架干预干预脑卒中肠内营养患者，构建了一套护理安全管理指标。更多还原

【Abstract】 Objective To study of the intervention effect of MDT team on aspiration in stroke patients under the framework of COSO-ERM, so as to provide clinical safety nursing standards to prevent aspiration.Methods 154 cases of stroke patients were selected prospectively as the intervention group, and 130 cases of stroke patients were selected retrospectively as the control group. MDT team were set up, responsibilities were assigned and specialist medical staff were trained. COSO-ERM framework was used to effectively intervene the occurrence of aspiration in stroke patients.Results There were significant differences in nasal feeding position, ventilation mode and feeding route, nutrient solution infusion mode and nutrient solution infusion speed between the two groups(P < 0.05). There were 12 cases of aspiration in the intervention group, the incidence was 7.79%, and 19 cases of aspiration occurred in the control group, the incidence of aspiration was 14.61%. There were significant differences between the two groups in the length of hospital stay,hospitalization cost, and the rate of target calorie reaching the standard(P < 0.05).Conclusion By implementing precise enteral nutrition nursing care for patients, the MDT team enhances the nutritional compliance rate, reduces the aspiration rates, and lowers economic costs. Utilizing the COSO-ERM framework to address enteral nutrition in stroke patients, a set of nursing safety management indicators was established.更多还原