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目的:探讨ICU患者肠内营养相关性腹泻护理中的问题，在行动中不断规范ICU护士预防和管理肠内营养相关性腹泻的护理实践。方法:采用便利抽样法，选取2019年10月—2020年6月在同济大学附属第十人民医院重症医学科行肠内营养治疗的367例ICU患者作为研究对象，根据时间分为3组：护理流程实践前129例（2019年10—12月）为对照组，行动研究第1轮循环117例（2020年1—3月）为行动1组，第2轮循环121例（2020年4—6月）为行动2组。通过小组访谈法识别肠内营养相关性腹泻护理中存在的问题，按照“计划—行动—观察—反思”的螺旋循环过程，制订和改进ICU预防和管理肠内营养相关性腹泻护理流程。比较3组腹泻发生率、持续时间、严重程度得分，采访护士的护理体验。结果:行动1组患者腹泻发生率低于对照组，持续时间少于对照组，严重程度得分低于对照组，差异有统计学意义（n P<0.05）。行动2组患者腹泻发生率低于行动1组，持续时间少于行动1组，严重程度得分低于行动1组，差异有统计学意义（n P<0.05）。对护士小组访谈提炼的主题有“萌发的科研兴趣”“解决临床问题的喜悦”“临床工作的受益”。n 结论:行动研究下的ICU预防和管理肠内营养相关性腹泻护理流程可降低腹泻的发生率、持续时间和严重程度，提高腹泻护理质量，提升护士职业获益感，激发护士科研兴趣。“,”Objective:To explore the nursing problems in ICU patients with enteral nutrition-related diarrhea and to constantly standardize the nursing practice of ICU nurses in the prevention and management of enteral nutrition-related diarrhea.Methods:Using convenience sampling method, 367 ICU patients who received enteral nutrition treatment in the Department of critical care medicine of the Tenth People's Hospital Affiliated to Tongji University from October 2019 to June 2020 were selected as the research objects. According to the time, they were divided into three groups: 129 cases before nursing process practice (October to December 2019) as the control group, 117 cases in the first round of action research (January to March 2020) as the action group 1, 121 cases in the second round of action research (April to June 2020) as the action group 2. A group interview method was used to identify problems in nursing of enteral nutrition-related diarrhea. According to the spiral cycle of “plan-action-observation-reflection”, the nursing procedure for prevention and management of enteral nutrition-related diarrhea in ICU was formulated and improved. The incidence, duration, and severity scores of diarrhea in the three groups were compared, and interview the nurse's nursing experience.Results:The incidence of diarrhea in action group 1 was lower than that of control group, duration was less than that of control group, and severity score was lower than that of control group, and the differences were statistically significant (n P<0.05) . The incidence of diarrhea in action group 2 was lower than that of action group 1, duration was less than that of action group 1, and severity score was lower than that of action 1 group, and the differences were statistically significant (n P<0.05) . The topics extracted from the group interviews with nurses included “emergent scientific interest” “the joy of solving clinical problems” “benefit from clinical work”.n Conclusions:The ICU nursing process of prevention and management of enteral nutrition-related diarrhea based on action research can significantly reduce the incidence, duration and severity of diarrhea, improve the quality of diarrhea nursing, enhance nurses' sense of career benefit and stimulate nurses' interest in scientific research.