建構電子化營養評估系統改善營養照護流程

Implementation of An Electronic Nutrition Assessment System to Improve Nutrition Care Process

林秀娟(Hsiu-Chuan Lin) ； 林建良(Chien-Liang Lin) ； 趙唯真(Wei-Chen Chao) ； 胡景齊(Ching-Chi Hu) ； 黃佳進(Jia-Jin Huang)

《臺灣膳食營養學雜誌》 8卷1期 (2016/06) Pp. 45-52

https://doi.org/10.6709/TJD.2016.0801.05

摘要

電子病歷的推動有助於醫療資源共享及減輕醫療團隊工作負擔，本專案目的為開發電子化營養評估系統，藉以簡化營養師工作流程、節省醫療成本及增加團隊溝通。資料收集為2013年10月至2015年3月期間營養師訪視的住院病人，分析該電子系統建立前後資料之各項指標成效。結果顯示，該系統建置一年後，每月營養師訪視訂餐病人人次，訪視病人食用治療伙食由每月32.3 ± 11.3人次提升至38.1 ± 10.3人次；管灌伙食由每月112.7 ± 23.8人次提升至168.3 ± 47.7人次。A4紙張支出量由每月192.7 ± 4.6張減至31.0 ± 3.5張，複寫紙使用量由每月11.3 ± 1.5張減少至0。醫師回覆率（%）由18.3 ± 0.3提升至61.4 ± 14.1，護理人員回覆率（%）由45.6 ± 3.7提升至60.6 ± 10.6。綜合上述結果可知，電子化營養評估系統的建立確實可帶來許多利益，不論在訪視人次、耗材成本及醫護回覆率都有呈現改善，可提供良好醫護溝通管道，對提升營養照護品質有益。

關鍵字

電子病歷 ； 電子營養評估系統 ； 治療伙食 ； 管灌伙食 ； 醫護回覆率

並列摘要

Electronic medical records enable the sharing of medical resources and alleviate the workload of medical teams. The objective of this project was to develop an electronic nutrition assessment and care system to simplify nutritionists’ workflow, reduce medical costs, and enable transparent team communication. Data was collected from inpatients visited by nutritionists between October 2013 and March 2015.Various indicators were employed to evaluate the performance before and after the e-system was established. The results revealed that after one year of system use, the frequencies to visit patients on therapeutic diet increased from 32.3 ± 11.3 to 38.1 ± 10.3 times per month, and those on tube feeding increased from 112.7 ± 23.8 to 168.3 ± 47.7 times per month. Sheets of A4- paper used to document nutrition care decreased from 192.7 ± 4.6 to 31.0 ± 3.5 sheets per month, and carbon-paper usage decreased from 11.3 ± 1.5 to 0 sheets per month. Further, the doctor’s response rates increased from 18.3% ± 0.3% to 61.4% ± 14.1%, and the nurse’s response rates increased from 45.6% ± 3.7% to 60.6% ± 10.6%. In summary, this study demonstrated the benefits of the establishment of an electronic nutrition assessment and care system. Substantial improvement was discovered in the number of patients visited, consumables used, doctor and nurse response rates. The system was effective to provide an communication channel and enhanced nutrition care quality.

並列關鍵字

electronic medical record ； electronic nutrition assessment system ； therapeutic diet ； tube feeding ； healthcare response rate