提升腹膜透析病人血色素之改善專案

Improving the Hemoglobin in Peritoneal Dialysis Patients

王郁薇(Yu-Wei Wang) ； 周雪琦(Hsueh-Chi Chou) ； 許薳尹(Wei-Yin Hsu)

《臺灣腎臟護理學會雜誌》 18卷1期 (2019/06) Pp. 16-30

https://doi.org/10.3966/172674042019061801002

摘要

本專案目的旨在提升腹膜透析病人的血色素，以改善病人貧血。經統計本腹膜透析室2015年病人的檢驗結果，有6個月血色素值大於8.5 g／dL的比率未達90％，低於醫院評鑑標準。專案小組經由現況分析得知問題導因為：營養不良、貧血衛教不足、病人未依醫囑施打紅血球生成素、鐵質缺乏以及血液流失等。透過跨團隊合作，文獻查證，提供高鐵高蛋白飲食衛教、貧血護理指導、制訂鐵劑補充作業規範並提供提示單、調整紅血球生成素劑型以提高注射遵從度。經專案改善後，連續追蹤5個月病人血色素值大於8.5 g／dL的比率均大於90％，已達醫院評鑑優良標準，病人血色素平均值由9.83 g／dL，提升至10.01 g／dL。此專案經驗與改善方案，可作為腹膜透析護理人員有效提升病人血色素之重要參考。

關鍵字

腹膜透析 ； 腎性貧血 ； 紅血球生成素

並列摘要

The project aims to improve hemoglobin in peritoneal dialysis patients to improve anemia in patients. In our PD center, the ratio of hemoglobin values greater than 8.5 g/dL for 6 months was less than 90% in 2015, which was lower than the hospital evaluation criteria. We analyzed that the main reasons of low hemoglobin level include: malnutrition, low consumption of high-iron content foods due to lack of knowledge, poor compliance on erythropoietin injections, iron deficiency, and blood loss etc. Cross-team cooperation, document verification, education on high-iron and high-protein diets, education on anemia care, formulation of iron supplement procedures and provide reminders and dosage adjustment for erythropoietin to improve compliance for injections were used for improvement. After improvement through the project, the rate of patients who were tracked continuously for five months with hemoglobin greater than 8.5 g/dL was over 90%. The experience and improvement program from this project can be used as an important reference for peritoneal dialysis nurses to effectively improve hemoglobin in patients.

並列關鍵字

peritoneal dialysis ； renal anemia ； erythropoietin

參考文獻

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