摂食嚥下時の誤嚥・咽頭残留アセスメントに関する看護ケアガイドライン

Abstract

Aim:The purpose of this clinical practice guideline is to provide and recommend methods of assessing aspiration and pharyngeal residue during eating and swallowing and methods of selecting and implementing nursing care for adults in order to prevent the development of aspiration pneumonia through early and appropriate management of oropharyngeal dysphagia.Methods: In April 2018, Japan Academy of Nursing Science established the Supervisory Committee in Nursing Care Development/Standardization Committee to develop clinical practice guidelines for aspiration and pharyngeal residual assessment during eating and swallowing for nursing care. This clinical practice guideline was developed in accordance with Minds Manual for Guideline Development 2017, with the aim of providing a specific pathway for nurses to determine the policy for selecting management for oropharyngeal dysphagia based on research evidence and multifaceted factors such as the balance of benefits and harms and patients' values.Results: Based on 10 clinical questions related to assessment by physical assessment, the Repetitive Saliva Swallowing Test, Modified Water Swallowing Test, Food Test, cervical auscultation, observation using an ultrasound diagnostic device, and an endoscope, 10 recommendations were developed. Eight recommendations were evaluated as GRADE 2C, and the other two were evaluated as no GRADE. Conclusion:We were able to produce the first reliable clinical practice guideline from an academic nursing organization that focuses on assessment for nursing care and incorporates the latest findings.