提升血液透析病患水分控制之專案

Improving Hemodialysis Patients Fluid Control Project

王正惠(Cheng-Hui Wang) ； 林佳玲(Chia-Ling Lin) ； 王美娥(Me-Er Wang) ； 吳桂芳(Kuei-Fang Wu) ； 周獻章(Hsien-Chang Chou) ； 江明哲(Ming-Che Chiang) ； 蔡幸(Hsing Tsai)

《臺灣腎臟護理學會雜誌》 13卷3期 (2014/09) Pp. 12-25

https://doi.org/10.3966/172674042014091303002

摘要

血液透析病患水份控制不佳易引發透析中血壓下降、抽筋等合併症，故本專案旨在提升血液透析病患之水份控制。本單位統計2010年1月1日至2010年3月31日透析1年（含）以上之病患，兩次透析間水份控制超過乾體重5%的比例為58.9%，藉由問卷分析原因為：護理人員缺乏護理指導技巧、病患對水份控制認知不足、未建立護理指導標準流程、護理指導單張不符合病人需求及口渴之生理等。本小組依對策矩陣分析表研擬對策為：舉辦在職教育訓練及團體護理指導；製作水份控制工具；制訂水份控制護理指導標準流程及護理指導單張。實施改善方案後，血液透析病患水份控制超過乾體重5%比例由58.9%降至25%，顯示本專案執行有顯著效益，不僅解決病患問題，也提升了照護品質。

關鍵字

血液透析 ； 水份控制 ； 乾體重

並列摘要

This project aimed to improve the interdialytic weight control of our patients on chronic hemodialysis. Large interdialytic weight gain, defined as greater than 5% of the dry weight, was recorded in 58.9% of our patients who had been dialyzed for more than one year. Factors included poor educational skills in nursing personnel, inadequate knowledge of patients, no standard procedure on education, impractical health education pamphlet, and physiological factors relating to patient thirst. Based on these factors, we planned laid out a strategy that included teaching program for nurses, group education for patients, development of a fluid control tool, and rephrasing of the fluid control pamphlet. Upon implementation the percentage of patients with large interdialytic weight gain dropped to 25%. The results show significant benefits from this project as it not only solved the patient problem but also improved the quality of nursing.

並列關鍵字

hemodialysis ； fluid control ； dry weight