提升腦中風病患之吞嚥困難篩檢正確率改善專案

A Program to Improve Accuracy Rate of Dysphagia Screening for Patients with Stroke

鍾欣伶(Hsin-Ling Chung) ； 陳亞玲(Ia-Ling Chen) ； 李慧玲(Hui-Lin Lee)

《志為護理-慈濟護理雜誌》 12卷3期 (2013/06) Pp. 89-101

摘要

腦中風病患常因吞嚥困難引發吸入性肺炎，故正確執行吞嚥困難篩檢十分重要。現況分析發現護理人員對腦中風病患吞嚥困難篩檢執行流程不一致且無正確標準程序，主因為缺乏吞嚥困難篩檢知識及技巧、訓練課程、專屬紀錄表單、標準作業流程及稽核制度。為提升執行吞嚥困難篩檢正確率及認知程度，故擬訂對策為規劃吞嚥困難篩檢在職教育、制訂吞嚥困難篩檢記錄表與稽核表、標準技術流程與監測指引及製作數位學習課程教材影片。結果顯示執行吞嚥困難篩檢正確率及認知程度皆提升至100%，吸入性肺炎發生率由19%降為7%，本專案成功提升執行吞嚥困難篩檢正確率及促進病患安全。

關鍵字

吞嚥困難 ； 腦中風 ； 吞嚥篩檢

並列摘要

Stroke patients often suffer from aspiration pneumonia due to dysphagia, thus performing swallowing screening test accurately is important. The current situation analysis found that the nurses of stroke patients conducting the swallowing screening test inconsistently and without a standard procedure, caused primarily by the lack of knowledge and skills on swallowing screening, and the absence of training programs, record forms, standard operating procedures and an audit system. This project aims to enhance the accuracy and the level of understanding of the swallowing screening test and its implementation. The countermeasures were: planning continuing education on swallowing test; develop swallowing screening test record form and audit form, swallowing screening standard programs and audit guidelines; and the production of digital learning videos. The results showed that the implementation of the countermeasures successfully raised the accuracy and the awareness level of swallowing screening to 100% and the occurrence of aspiration pneumonia reduced from 19% to 7%. The project did effectively enhance the accuracy of swallowing screening test and in turn promoted patient safety.

並列關鍵字

dysphagia ； stroke ； swallowing screen