降低腎臟科病房腹膜透析病人腹膜炎發生率

腹膜炎是腹膜透析常見的併發症，當發生嚴重腹膜炎，可能面臨移除腹膜透析管甚至死亡，不僅影響病人生活品質，也延長住院天數。2019年腎臟科病房腹膜透析病人腹膜炎發生率1.8次／100人月，高於臺灣腎臟醫學會腹膜透析訪視作業評量之腹膜炎發生率1.7次／100人月，因此引發專案動機，成立專案小組，經調查發現換液技術操作錯誤、未正確洗手、自我照護知識不足、缺乏合適衛教工具、無稽核制度及教育訓練，於2020年6月1日至10月31日實施改善對策：加強病人自我照顧認知與技能、增加字體放大及外語衛教本，製作QR Code換液影片、舉辦團體衛教、教育訓練及海報宣導，提升病人和照顧者正確自我照顧能力，結果腹膜炎發生率由1.8次／100人月降至1.6次／100人月，有效達預期目標。

關鍵字

腹膜炎；腹膜透析；發生率

並列摘要

Peritonitis is a common complication in peritoneal dialysis patients. Severe cases of peritonitis can lead to the removal of the peritoneal dialysis tube or, in extreme circumstances, result in fatal outcomes. This not only adversely affects the patient's quality of life but also extends their hospital stay duration. In 2019, the incidence of peritonitis among peritoneal dialysis patients within the nephrology was 1.8 patients per month per 100 patients. This rate exceeded the peritonitis incidence rate of 1.7 patients per month per 100 patients as assessed by the Taiwan Society of Nephrology for Peritoneal Dialysis Visits. We identified several contributing factors to the high peritonitis rates. These included improper fluid replacement techniques, inadequate hand hygiene practices, insufficient patient knowledge regarding self-care, a lack of appropriate health education and training resources, and deficiencies in the audit system. A series of improvement measures were implemented between June 1 and October 31, 2020. These measures included various strategies aimed at enhancing patient self-care awareness and skills. We revised health educational materials with larger fonts and foreign language translations, developed informative videos accessible via QR Code scanning, organized group health education and training sessions, and introduced informational posters to promote correct self-care practices among patients and their caregivers. The outcome was a notable reduction in the incidence of peritonitis. In the subsequent year, the rate decreased from 1.8 patients per month per 100 patients to 1.6 patients per month per 100 patients.

並列關鍵字

peritonitis ； peritoneal dialysis ； incidence

參考文獻

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