腦中風病人吞嚥訓練改善方案

Swallow Training Improvement for Cerebrovascular Accident Patients

柯麗芬(Li-Fen Ko) ； 周美香(Mei-Hsiang Chou) ； 陳秀英(Hsiu-Ying Chen) ； 林妙璦(Miaw-I Lin)

《榮總護理》 27卷1期 (2010/03) Pp. 36-42

https://doi.org/10.6142/VGHN.27.1.36

摘要

本專案旨在提升病房護理人員對腦中風留置鼻胃管的病人做吞嚥訓練的執行率，減少吞嚥障礙發生嗆食的不良影響。本單位回溯60本病歷資料，護理人員對腦中風鼻胃管留置病人做吞嚥訓練執行率僅40%，分析執行率低的主因為：65%的護理人員對吞嚥訓練缺乏知識與技巧、醫護間對吞嚥訓練沒有共識、家屬擔心病人嗆食而中斷。針對上述擬定對策：實施護理人員在職教育訓練、製作吞嚥訓練執行步驟、與醫師共同討論並製作吞嚥訓練篩選表及稽核。對策實施後護理人員吞嚥訓練執行率提升到90%，更增加護理專業附帶效益，移除病人鼻胃管。

關鍵字

腦中風 ； 吞嚥訓練

並列摘要

In order to improve the execution rate of swallow training, we carried out a site training program for nurses, established swallow training guidelines, and discussed with doctors to create swallow training ”swift and check” forms. After the abovementioned interventions were performed, the swallow training performing rate increased to 90% and hence, allowing patients' NG tube to be removed earlier.
Swallow training can reduce incidents of chocking. In our unit, we reviewed 60 patients' medical histories and found that only 40% of nurses had performed swallow training on CVA patients with a nasogastric tube. After this research, we indicated the factors causing low performing rate were: Insufficient knowledge or professional skills of nurses in swallow training (65%) and inadequate consensus between doctors and nurses. Moreover, manyfamilymemberswereconcernedaboutpatientsbeingchockduringtraining, therefore, the training was stopped.
The main purpose of this project is to improve the execution rate of swallow training by nurses for cerebralvascular accident (CVA) patients with a nasogastric tube (NG tube).

並列關鍵字

cerebrovascular accident ； swallowing dysfunction