- 期刊
提升主要照顧者執行居家靜脈營養照護之正確率
Improve the Accuracy Rate of Primary Caregivers in Implementing Home Parenteral Nutrition Care
摘要
本專案旨在提升主要照顧者執行居家靜脈營養照護的正確率，減少併發症發生。本單位以腸胃道癌症病人為主，當病人無法經腸胃道攝取營養時，靜脈營養成為唯一的營養來源。臨床觀察到主要照護者為執行居家靜脈營養照護感到憂心，深入探討發現主要照顧者執行居家靜脈營養照護正確率僅52.5%。分析主要問題:學習者常更換、衛教內容過於繁瑣、實際操作機會少、護理人員缺乏相關教育課程、輔助工具、標準作業流程及審核工具。經問題確立及文獻參考後，擬定改善措施：製作居家靜脈營養照護影片、QR Code、衛教指導手冊、擬真輸液管路模組、制定居家靜脈營養照護正確率審核表，使主要照護者執行居家靜脈營養照護正確率由52.5%提升至90%，同時也縮短護理人員衛教時間。
並列摘要
The purpose of this project is to improve the rate of accurate provision of home parenteral nutrition care by primary caregivers to reduce the risk of complications. For patients with gastrointestinal cancer, who constitute the majority of patients at this hospital department, parenteral nutrition is the only source of nutrition accessible to them because they cannot take in nutrition through the gastrointestinal system. Clinical observations revealed that the primary caregivers providing home parenteral nutrition care were concerned about their ability to provide proper care. An in-depth investigation showed a low rate of accurate home parenteral nutrition care by these primary caregivers, at 52.5%. This low rate is mainly caused by the high learner turnover, the intricate content of health education, the limited opportunities for practice, the lack of related courses and auxiliary tools for nurses, and the lack of standard operating procedure and assessment tools. Based on the identified problems and a literature review, improvement measures were proposed: making videos on home parenteral nutrition care, producing quick-response codes that link to related content, developing instructional manuals on the health education, creating a simulation module of intravenous catheters, and developing an assessment form for the provision of home parenteral nutrition care. These measures improved the rate of accurate provision of home parenteral nutrition care by primary caregivers from 52.5% to 90% and shortened the amount of time nurses spent on providing health education.