- 期刊
運用圖像記憶法降低血液透析病人之高血磷專案
Hyperphosphatemia Project on Lowering Serum Phosphate in Dialysis Patients Using the Image Memory Method
摘要
高血磷會引起副甲狀腺亢進繼發腎性骨病變，也和透析病人心血管死亡率和住院率的增加有關。本單位高血磷的問題一直存在，它影響副甲狀腺亢進是否可用維生素D3治療的關鍵。據2013年統計，本單位因高血磷併發副甲狀腺亢進，無法以維生素D3治療改善，需行副甲狀腺切除術者有27人，佔6.69％，不僅增加醫療成本，更影響透析品質，故成立本專案小組，以降低血中磷值。分析後，以攝取高磷飲食、忘記服藥所佔的比例最高，改善對策有設計圖像記憶（食物圖片轉盤、電腦動畫）、鑰匙圈鈣片盒等方法。實施後，血中磷值高於6.0 mg/dl的病人，由2013年8月24.75％降至 2014年5月18.8％。透過此專案執行，可增進同仁專業能力，更達到提升照護品質之最終目的。
並列摘要
Hyperphosphatemia not only leads to renal osteodystrophy but is also related to the patient mortality and hospitalization rates. Hyperphosphatemia has been a longstanding problem in this unit as it affects whether hyperparathyroidism can be cured by Vitamin D3 or not. According to the statistics for 2013, hyperphosphatemia concurrent with hyperthyroidism that couldn’t be cured with Vitamin D3 necessitated parathyroidectomy for 27 people, or 6.69% of all cases. The problem not only increase the medical cost but also affected the quality of hemodialysis. An ad hoc group was therefore established to reduce phosphatemia. Analysis found that the eating of high high-phosphorus food and forgetting to take the medication were the most common problems. Improvements such as image memory (food image disc, computer animation) and key rings with calcium tablet boxes were implemented. After these measures were implemented, the number of patients with phosphatemia over 6.0 mg/dl decreased from 24.75% in August 2013 to 18.8% in May 2014. The implementation of the project enhanced the professional ability of nursing personnel and realized the ultimate goal of improving the quality of care.