Abstract：
BACKGROUND: Dysphagia and malnutrition are major contributors to mortality in patients with acute stroke. An early assessment of nutritional status upon hospital admission is crucial to enhance clinical outcomes by reducing the associated high-risk complications. However, the fragmented nature of the existing literature makes it difficult to optimize clinical practices.
OBJECTIVE: This study aims to identify the best clinical practices that nurses and other healthcare professionals can employ for the immediate assessment of nutritional risk in patients diagnosed with acute stroke.
METHODS: Systematic review of clinical practice guidelines and systematic reviews.
METHODS: Comprehensive bibliographic searches were conducted up to May 2024 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines across the databases Cochrane Library, PubMed, Embase, CINAHL, and Scopus, and three recognized guideline repositories.
METHODS: The quality of clinical practice guidelines was ascertained using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument, and the quality of systematic reviews was assessed through A MeaSurement Tool to Assess Systematic Reviews (AMSTAR 2). The evidence quality was appraised based on the classifications by the European Society of Cardiology.
RESULTS: Out of 2534 identified records, 15 were incorporated into this review. Predominantly, the selected clinical practice guidelines and systematic reviews exhibited high methodological quality. Notably, the Gugging Swallowing Screen and the Malnutrition Universal Screening Tool were pinpointed as primary tools for initial screenings. Most studies recommended that these assessments, ideally conducted within the first 24 h of patient admission, should be carried out by specially trained professionals, highlighting the pivotal role of nurses. Deviations in screening outcomes necessitate complementary specialist evaluations.
CONCLUSIONS: This systematic review offers a consolidation of current insights, proposing an innovative and integrated approach to assess nutritional needs of high-risk patients. It underscores the importance of nurses in the screening process, emphasizing their pivotal role in the nutritional management of patients with acute stroke, and advocates for further research endeavors to standardize intervention protocols to elevate patient clinical outcomes.
UNASSIGNED: PROSPERO CRD42023425140.
OBJECTIVE: This study aims to identify the best clinical practices that nurses and other healthcare professionals can employ for the immediate assessment of nutritional risk in patients diagnosed with acute stroke.
METHODS: Systematic review of clinical practice guidelines and systematic reviews.
METHODS: Comprehensive bibliographic searches were conducted up to May 2024 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines across the databases Cochrane Library, PubMed, Embase, CINAHL, and Scopus, and three recognized guideline repositories.
METHODS: The quality of clinical practice guidelines was ascertained using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument, and the quality of systematic reviews was assessed through A MeaSurement Tool to Assess Systematic Reviews (AMSTAR 2). The evidence quality was appraised based on the classifications by the European Society of Cardiology.
RESULTS: Out of 2534 identified records, 15 were incorporated into this review. Predominantly, the selected clinical practice guidelines and systematic reviews exhibited high methodological quality. Notably, the Gugging Swallowing Screen and the Malnutrition Universal Screening Tool were pinpointed as primary tools for initial screenings. Most studies recommended that these assessments, ideally conducted within the first 24 h of patient admission, should be carried out by specially trained professionals, highlighting the pivotal role of nurses. Deviations in screening outcomes necessitate complementary specialist evaluations.
CONCLUSIONS: This systematic review offers a consolidation of current insights, proposing an innovative and integrated approach to assess nutritional needs of high-risk patients. It underscores the importance of nurses in the screening process, emphasizing their pivotal role in the nutritional management of patients with acute stroke, and advocates for further research endeavors to standardize intervention protocols to elevate patient clinical outcomes.
UNASSIGNED: PROSPERO CRD42023425140.
摘要：
背景：吞咽困难和营养不良是急性卒中患者死亡的主要原因。入院后对营养状况的早期评估对于通过减少相关的高风险并发症来提高临床结局至关重要。然而,现有文献的零散性使得优化临床实践变得困难.
目的：本研究旨在确定护士和其他医疗保健专业人员可用于即时评估急性卒中患者营养风险的最佳临床实践。
方法：临床实践指南的系统评价和系统评价。
方法：根据CochraneLibrary数据库的系统审查和荟萃分析（PRISMA）指南，在2024年5月之前进行了全面的书目搜索，PubMed,Embase,CINAHL,还有Scopus,和三个公认的指南库。
方法：使用评估指南II（AGREEII）工具确定临床实践指南的质量，系统评价的质量通过评估系统评价的MeaSurement工具(AMSTAR2)进行评估。根据欧洲心脏病学会的分类对证据质量进行了评估。
结果：在2534条确定的记录中，15个被纳入本审查。主要是,选定的临床实践指南和系统评价显示了较高的方法学质量.值得注意的是,Gugging吞咽屏幕和营养不良通用筛查工具被确定为初始筛查的主要工具。大多数研究建议这些评估，理想情况下在患者入院的前24小时内进行，应由受过专门培训的专业人员进行，强调护士的关键作用。筛查结果的偏差需要补充专家评估。
结论：本系统综述整合了当前的见解，提出了一种创新的综合方法来评估高危患者的营养需求。它强调了护士在筛查过程中的重要性，强调它们在急性中风患者的营养管理中的关键作用，并倡导进一步的研究努力，以标准化干预方案，以提高患者的临床结果。
■PROSPEROCRD42023425140。
目的：本研究旨在确定护士和其他医疗保健专业人员可用于即时评估急性卒中患者营养风险的最佳临床实践。
方法：临床实践指南的系统评价和系统评价。
方法：根据CochraneLibrary数据库的系统审查和荟萃分析（PRISMA）指南，在2024年5月之前进行了全面的书目搜索，PubMed,Embase,CINAHL,还有Scopus,和三个公认的指南库。
方法：使用评估指南II（AGREEII）工具确定临床实践指南的质量，系统评价的质量通过评估系统评价的MeaSurement工具(AMSTAR2)进行评估。根据欧洲心脏病学会的分类对证据质量进行了评估。
结果：在2534条确定的记录中，15个被纳入本审查。主要是,选定的临床实践指南和系统评价显示了较高的方法学质量.值得注意的是,Gugging吞咽屏幕和营养不良通用筛查工具被确定为初始筛查的主要工具。大多数研究建议这些评估，理想情况下在患者入院的前24小时内进行，应由受过专门培训的专业人员进行，强调护士的关键作用。筛查结果的偏差需要补充专家评估。
结论：本系统综述整合了当前的见解，提出了一种创新的综合方法来评估高危患者的营养需求。它强调了护士在筛查过程中的重要性，强调它们在急性中风患者的营养管理中的关键作用，并倡导进一步的研究努力，以标准化干预方案，以提高患者的临床结果。
■PROSPEROCRD42023425140。
