Application Review and Barrier Analysis of the Best Evidence for the Preventive Care of Nasal Mucosal Pressure Injury in ICU Patients with Nasal Tube Placement

Jinjie SONG; Ting LI; Qi GUO; Siqi XIONG; Bingjing LU; Ying HUANG

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Article Navigation > Journal of Kunming Medical University > 2026 > Accepted Manuscript

Jinjie SONG, Ting LI, Qi GUO, Siqi XIONG, Bingjing LU, Ying HUANG. Application Review and Barrier Analysis of the Best Evidence for the Preventive Care of Nasal Mucosal Pressure Injury in ICU Patients with Nasal Tube Placement[J]. Journal of Kunming Medical University.

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Application Review and Barrier Analysis of the Best Evidence for the Preventive Care of Nasal Mucosal Pressure Injury in ICU Patients with Nasal Tube Placement

Jinjie SONG^{1, 2},
Ting LI³,
Qi GUO^{1, 2},
Siqi XIONG²,
Bingjing LU³,
Ying HUANG^{2
,
,}

1.
Nursing School of Kunming Medical University，Kunming Yunnan 650500
2.
Emergency Ward，Yan’an Hospital，Kunming Yunnan 650051
3.
Nursing School of Yunnan University of Traditional Chinese Medicine，Kunming Yunnan 650500，China

Received Date: 2025-01-20

Abstract

Abstract

Objective To evaluate the current clinical application of evidence for preventing nasal mucosal pressure injury in patients with nasal catheterization in the intensive care unit, develop audit criteria, analyze obstacles and facilitating factors, and formulate corresponding improvement strategies. Methods According to the JBI evidence-based healthcare model, best nursing strategies for the prevention of nasal mucosal pressure injury in patients with nasal tube placement were developed. Corresponding audit criteria were formulated, and a clinical audit was conducted from March to June 2025, involving 60 ICU patients with nasal tube placement and 27 nurses from the Department of Critical Care Medicine in a tertiary hospital in Kunming. According to the i-PARIHS conceptual framework, obstacles and facilitators during the implementation phase were analyzed from three aspects: "innovation, recipients and context", and the corresponding implementation strategies were constructed. Results A total of 20 pieces of best evidences were ultimately included, based on which 30 audit criteria were developed. Only 8 criteria achieved 100% clinical compliance, 9 criteria had compliance rate below 60%, and another 11 criteria had a clinical compliance rate of zero. Major obstacles included the lack of corresponding evaluation and nursing process, insufficient attention to nasal care among nursing staff, and immature training and assessment mechanisms. Facilitators included positive attitude of nurses, good cooperation between medical and nursing care, strong support from change leaders, and a solid scientific research foundation. After implementing the targeted strategies, 27 of the 30 audit criteria reached 100% compliance. Conclusion There is a significant gap between the evidence for the prevention of nasal mucosal pressure injury and its clinical application. Accurately identifying facilitators and obstacles in the implementation process and implementing targeted interventions can effectively promote the integration of evidence-based practices into clinical care.
- Department of Critical Care Medicine,
- Nasal intubation,
- Pressure injury of nasal mucosa,
- Audit criteria,
- Barriers,
- Evidence-based practice

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References(28)

References

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