運用跨團隊合作模式提升血液腫瘤病人對營養認知之正確率

Increasing Accuracy of Nutrition Recognition of Hematology Patients by Interdisciplinary Cooperation

李姵萱(Pei-Hsuan Lee) ； 洪燕萍(Yen-Ping, Hung)

《臺大護理雜誌》 15卷1期 (2019/01) Pp. 146-159

https://doi.org/10.6740/NTUHJN.201901_15(1).0014

摘要

背景：血液腫瘤病人在接受化學治療的過程中可能因營養攝取不足而影響其治療計畫，故本專案旨在提升血液腫瘤病人對營養認知之正確率，以降低病人營養不良之發生。專案執行期間為2016年6月至12月，藉由現況分析發現病人營養認知正確率僅38.2%，主因包括現行病人營養衛教內容不足、護理師無法有效指導病人選擇正確的營養補充品及治療飲食、營養篩檢評估未電子化、單位短期內頻繁更換營養師、營養篩檢再評估不完整。目的：病人營養認知正確率由38.2%提升為80.0%。解決方案：加強營養篩檢再評估、儘早照會營養師、修訂護理指導手冊、舉辦團體護理指導及營養照護教育訓練、推行營養篩檢評估電子化、協調專責營養師提供個別性飲食計畫。結果：病人營養認知正確率由38.2%提升至90.0%。結論：建議其他癌症相關單位亦能藉跨團隊合作模式共同評估病人的營養照護需求，提供正確營養認知，以降低化學治療相關副作用的嚴重程度。

關鍵字

血液腫瘤 ； 跨領域 ； 營養照護

並列摘要

The treatment plan of hematology patients might be changed because of malnutrition during the period of chemotherapy. Therefore, this project aimed for increasing accuracy of nutrition recognition of hematology patients to decrease the incidence of malnutrition. This project executed from June to December 2016. The members of this project found that only 38.2% accuracy of nutrition recognition of patient. The reasons included: insufficiency of current nutrition education for patients; nurses unable to guide patients to choose the appropriate nutrition supplement and treatment diet; non-digitalized nutrition assessment; frequent replacement of dietitian; incompleteness of nutrition re-evaluation. The interventions of this project included: enhance the nutrition re-assessment; consult the dietitian as soon as possible; revise the nutrition guidance; hold group nutrition education and workshop; have nutrition evaluation assessment digitalized; coordinate interdisciplinary dedicated dietitians to provide customized diet approaches. Result: The accuracy of nutrition recognition of patients significantly increases from 38.2% to 90.0%. We suggested that by teaming up with different groups, it is possible to evaluate the necessity of patients' nutrition care, therefore, correct nutrition facts and recognitions are delivered. That reduced severity of chemotherapy related side-effects.

並列關鍵字

hematology ； interdisciplinary ； nutrition care