- 期刊
提升居家鼻胃管灌食個案營養照護成效專案
Using Blenderized Food to Improve Nutritional Status for Home Care Clients with Nasogastric Tube
摘要
本專案旨在改善居家護理師執行營養評估與飲食指導作業，期望讓居家使用鼻胃管灌食者改善營養不良狀況，增進抵抗力，減少疾病合併症及再住院率。此專案以南部某區域教學醫院附設居家護理所個案、家屬及居家護理師為收案對象，自2010年1月至6月以問卷調查表、實地訪談、查閱護理紀錄等方式收集資料，根據現況分析發現問題有：居家護理師對長期照護個案營養認知程度低，測驗結果為65分；居家護理師對居家個案營養評估執行率低僅62.0%；居家個案營養篩檢（Mini Nutritional Assessment, MNA）結果，屬營養狀況良好者僅佔18.5%。經由專案介入措施包括加強居家護理師在職教育，定訂「居家護理個案營養評估監測流程」，依照所製訂之「居家護理營養評估單」定期評估個案營養狀況，並設計「個人化營養圖卡」針對個案疾病別、營養缺失情況及家庭經濟考量設計菜單，並協助挑選合適之配方管灌或提供攪打配方食譜，結果顯示居家護理師對長期照護個案營養認知程度提昇至100分，居家護理師對居家個案營養評估執行率達100.0%，居家個案營養篩檢結果，屬營養不良者由21.6%下降為13.6%。由此可見強化居家護理師對營養飲食認知的能力並落實居家護理營養評估，定期監測並設計合適之飲食計畫有助於改善居家照護個案營養不良狀況。
並列摘要
This study aims to improve the activities of nutritional evaluation and diet instruction among home care nurses in southern Taiwan. Following the study, the nutritional status, disease complication, and hospitalization rates of home care clients undergoing nasogastric tube feeding are expected to be reduced. Home care clients, their families, and the home care nurses from a regional teaching hospital were invited to participate in this study. Data were collected from January 2010 to June 2010 using a questionnaire, interview, and nursing record review. Data revealed that nutritional knowledge of home care nurses was low (65 points), with only a 62.0% nutritional assessment rate. In addition, only 18.5% of clients presented as well-nourished according to the Mini Nutritional Assessment. In-service education, a ”home nursing care nutritional assessment monitoring process,” and an ”individualized nutrition card” were provided. The nutritional knowledge of home care nurses increased (100 points), and the nutritional assessment rate was 100.0%. The results of nutritional assessment revealed that 28.4% of clients were well-nourished. In conclusion, increasing nutritional knowledge for home care nurses, implementing home nutritional assessment, regular monitoring, and designing individualized diet plans can improve the nutritional status of home care clients.
延伸閱讀
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- 白淑芬、蔡美玲、陳華玉、蔡美菊（2013）。提昇居家護理個案鼻胃管移除率。長期照護雜誌，17(3)，315-329。https://doi.org/10.6317/LTC.201312_17(3).0010
- 吳虹諗、張巧惠、陳麗貞、林梅香、謝春蘭（2015）。加護病房護理人員鼻胃管灌食照護完整性之改善專案。長庚護理，26(1)，53-65。https://doi.org/10.3966/102673012015032601006
- 蔡淑美、李淑桂、洪郁雯、蔡婉蓉（2011）。提昇護理人員執行鼻胃管留置病患相關衛教完整率。中山醫學雜誌，22(1)，129-139。https://doi.org/10.30096/CSMJ.201103.0014
- 吳紅蓮、董莉莉、王明誠（2018）。Investigation of the Nutritional Status and Appetite Assessments in Maintenance Hemodialysis Patients。台灣營養學會雜誌，42(3)，80-88。https://doi.org/10.6691/NSJ.201809_42(3).0001