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已发表论文
提升老年髋部骨折患者围手术期口服营养补充剂的应用：一项基于循证实践的试点项目
Authors Xie Y , Li X, Yang T, Yang H, Pan W , Cheng C
Received 4 September 2025
Accepted for publication 23 December 2025
Published 31 December 2025 Volume 2025:20 Pages 2773—2790
DOI https://doi.org/10.2147/CIA.S562166
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Maddalena Illario
Yu Xie,1 Xin Li,1 Tingting Yang,2 Huimin Yang,1 Weiyu Pan,1 Cheng Cheng3
1Department of Orthopedics, Henan Provincial Intelligent Nursing and Transformation Engineering Research Center, Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People’s Hospital; Zhengzhou University People’s Hospital, Zhengzhou, Henan, 450003, People’s Republic of China; 2Department of Clinical Nutrition, Henan Provincial People’s Hospital; Zhengzhou University People’s Hospital, Zhengzhou, Henan, 450003, People’s Republic of China; 3Department of Orthopedics, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Zhengzhou, Henan, 450003, People’s Republic of China
Correspondence: Cheng Cheng, Email cc_hust@163.com Weiyu Pan, Email panweiyu@126.com
Objective: This study aimed to integrate the most robust evidence on perioperative oral nutritional supplementation (ONS) for elderly patients with hip fractures into clinical practice and to evaluate its effectiveness.
Methods: Using an evidence-based continuous quality improvement model, we synthesized the best available evidence with the specific clinical context of the research institution, translated it into review indicators and implementation plans, and conducted a baseline audit to identify barriers and facilitators. Based on these findings, a targeted action plan was developed and implemented. Evidence-based interventions were incorporated into routine clinical practice from January 2024 to October 2024. Outcomes before and after implementation were compared, including medical staff knowledge of nutrition and related topics, discharge NRS2002 scores, discharge nutritional risk, serum albumin levels,prognostic nutritional index (PNI), length of hospital stay, number of complications, and adherence to review indicators.
Results: A total of 49 cases before and 44 cases after the implementation of evidence-based practice were analyzed. Post-implementation, adherence to the review indicators improved significantly, with overall compliance increasing from 0– 10.7% to 25– 100% (P < 0.05). Medical staff knowledge scores on nutrition and related topics increased significantly from (61.07± 12.36) to (85.57± 16.89) (t = 6.195, P < 0.001). In addition, after implementation, discharged patients showed significantly lower nutritional risk and NRS2002 scores, as well as improved PNI (P < 0.05). Although discharge serum albumin levels increased and both length of hospital stay and number of complications decreased, these changes did not reach statistical significance.
Conclusion: This pilot project demonstrates that implementing an evidence-based protocol for perioperative ONS in elderly hip fracture patients is both feasible and effective. The intervention significantly improved healthcare staff knowledge, enhanced adherence to care standards, and reduced patients’ nutritional risk, thereby supporting faster recovery and promoting continuous quality improvement in nursing care.
Keywords: aged, hip fracture, oral nutritional supplementation, specialized medical formula foods, nutrition, evidence-based nursing practices
1Department of Orthopedics, Henan Provincial Intelligent Nursing and Transformation Engineering Research Center, Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People’s Hospital; Zhengzhou University People’s Hospital, Zhengzhou, Henan, 450003, People’s Republic of China; 2Department of Clinical Nutrition, Henan Provincial People’s Hospital; Zhengzhou University People’s Hospital, Zhengzhou, Henan, 450003, People’s Republic of China; 3Department of Orthopedics, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Zhengzhou, Henan, 450003, People’s Republic of China
Correspondence: Cheng Cheng, Email cc_hust@163.com Weiyu Pan, Email panweiyu@126.com
Objective: This study aimed to integrate the most robust evidence on perioperative oral nutritional supplementation (ONS) for elderly patients with hip fractures into clinical practice and to evaluate its effectiveness.
Methods: Using an evidence-based continuous quality improvement model, we synthesized the best available evidence with the specific clinical context of the research institution, translated it into review indicators and implementation plans, and conducted a baseline audit to identify barriers and facilitators. Based on these findings, a targeted action plan was developed and implemented. Evidence-based interventions were incorporated into routine clinical practice from January 2024 to October 2024. Outcomes before and after implementation were compared, including medical staff knowledge of nutrition and related topics, discharge NRS2002 scores, discharge nutritional risk, serum albumin levels,prognostic nutritional index (PNI), length of hospital stay, number of complications, and adherence to review indicators.
Results: A total of 49 cases before and 44 cases after the implementation of evidence-based practice were analyzed. Post-implementation, adherence to the review indicators improved significantly, with overall compliance increasing from 0– 10.7% to 25– 100% (P < 0.05). Medical staff knowledge scores on nutrition and related topics increased significantly from (61.07± 12.36) to (85.57± 16.89) (t = 6.195, P < 0.001). In addition, after implementation, discharged patients showed significantly lower nutritional risk and NRS2002 scores, as well as improved PNI (P < 0.05). Although discharge serum albumin levels increased and both length of hospital stay and number of complications decreased, these changes did not reach statistical significance.
Conclusion: This pilot project demonstrates that implementing an evidence-based protocol for perioperative ONS in elderly hip fracture patients is both feasible and effective. The intervention significantly improved healthcare staff knowledge, enhanced adherence to care standards, and reduced patients’ nutritional risk, thereby supporting faster recovery and promoting continuous quality improvement in nursing care.
Keywords: aged, hip fracture, oral nutritional supplementation, specialized medical formula foods, nutrition, evidence-based nursing practices