目的 了解成人重型颅脑损伤患者肠内营养支持证据临床应用现状，分析循证护理实践中的障碍因素、促进因素，为证据的临床转化提供依据。 方法 以基于证据的持续质量改进模式为理论指导，检索、评价及汇总最佳证据，制定审查指标，根据基线审查结果分析障碍及促进因素。 结果 根据11条最佳证据制定18条审查指标，12条指标依从率＜60%，其中6条指标依从率为0。障碍因素主要为缺乏规范化流程、医护人员相关知识欠缺、培训不足等。 结论 本研究基于最佳证据制定的质量审查指标具有科学性、规范性及可操作性，可针对障碍因素及促进因素实施临床变革及管理改进，促进证据转化。

Objective To explore the clinical application status of evidence for enteral nutrition support in adult patients with severe head injury,and to analyze the obstacles and promoting factors in the implementation of evidence-based nursing,thus to provide basis for clinical transformation of evidence. Methods Under the theoretical guidance of the evidence-based continuous quality improvement model,the evidence was searched,evaluated and summarized.Review indicators were developed.Obstacles and promoting factors according to the results of the baseline review were analyzed. Results Totally 18 quality examination indexes were formulated according to the 11 best evidence.The compliance rate of 12 indicators was less than 60%.Among them,compliance rates of 6 indicators were 0.The main obstacle factors were lack of standardized process,relevant knowledge of medical staff,and training. Conclusions The quality examination index based on the best evidence in this study is scientific,standardized and practical,which can implement clinical reform and management improvement according to the obstacle factors and promoting factors,and promote the transformation of evidence.

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国家临床重点专科建设项目（国卫办医函〔2018〕292号）