- 期刊
提升神經外科重症病人營養評估完整率之改善專案
Project to Promote the Complete of Nutrition Assessment in Neurosurgical Intensive Care Unit
摘要
加護病房重症病人約有90%以上會有營養不良狀況，應及早提供適切的營養照護；本單位為神經外科加護病房，經調查發現護理人員對重症病人營養評估完整率僅62.4%，原因為：營養評估認知正確率僅達63.7%、測量身高基準不一、缺乏營養評估輔助工具、僅依醫囑給予灌食、高危險篩選表不符合專科特性及可控的禁食天數平均達5.8天。自2011年3月1日至8月31日，專案成員參考文獻擬定改善方案包括：（1）修訂神經外科重症病人營養不良評估暨處置標準；（2）營養不良高危險因子連結病人健康問題；（3）推動早食策略；（4）運用電腦系統計算熱量；（5）推展身高反推法；（6）舉辦專科營養評估教育訓練。最後營養評估完整率提升為97.7%及可控的禁食天數平均降為3天，足見方案有效改善問題，期望藉此提升醫護團隊對營養評估的重視並提供適切的營養照護。
並列摘要
About 90% of the patients staying in the intensive unit have malnutrition problems. The project participants comprised of nursing staff from a neurosurgical intensive care unit. Based on our evaluation, the nutrition assessment accuracy at this unit was merely 62%. There were several issues related to the problem, insufficient knowledge about nutrition assessment among nursing staff (63.7%), inconsistency of height measurement, lack of nutrition assessment tool, insufficient individualized nutrition assessment, inappropriate high-risk screening list, and long fasting period for patients (5.8 days). The improvement project was from March 1, 2011 to August 31, 2011. After analyzing the current procedures, the proposed improvement project included: (1) revising nutrition assessment tool and malnutrition process procedures; (2) linking malnutrition risk factors to patient's nursing problems; (3) carrying out the early-feeding intervention; (4) calculating calorie intake by the computer system; (5) applying height estimation method; and (6) arranging nutrition assessment training. After the improvement project, the completeness rate of nutrition assessment increased to 97.7%, and the average control fasting period decreased to 3 days. The project has improved the nutrition assessment and provided adequate nutrition care in the neurosurgical intensive care unit.
延伸閱讀
- 鄭青青、張乃丹、林幼麗、賀倫惠、余文彬、郭惠敏（2017）。提昇神經內科病房院內急救完整性之專案。長庚護理，28(1)，85-99。https://doi.org/10.3966/102673012017032801008
- 盧育汶、白筱雯、李彩緣、屈靈怡（2015）。提升重症病人轉送過程完整性之改善專案。若瑟醫護雜誌，9(1)，62-72。https://www.airitilibrary.com/Article/Detail?DocID=1819026x-201507-201508070009-201508070009-62-72
- 徐愬美、楊宜霖、葉惠慈、李文瑞、孫瑤光（2017）。提升醫療團隊間病人攝入輸出量交班成效之專案。新臺北護理期刊，19(1)，59-70。https://doi.org/10.6540/NTJN.2017.1.006
- 黃詩筑、曾莉晴、蘇虹頤、江佩雯（2023）。提升神經外科加護病房護理人員資訊化交班完整性之改善專案。志為護理-慈濟護理雜誌，22(1)，71-82。https://www.airitilibrary.com/Article/Detail?DocID=16831624-N202302230003-00017
- 彭沛語、鄭秋子、李映春、石惠美、李夢英、吳寶媛（2018）。A Project to Improve the Completeness of Nursing Record in Post-Anesthesia Care Unit。志為護理-慈濟護理雜誌，17(5)，101-112。https://www.airitilibrary.com/Article/Detail?DocID=16831624-201810-201810230007-201810230007-101-112