A Project to Reduce the Serum Phosphoric Value for the Dialysis Patient with Hyperphosphatemia
余美玲(Me-iLin Yu)；黃雪萍(Hsueh-Ping Huang)；柯維容(Wei-Rung Ko)；鄒海月(Hai-Yueh Tzou)
血液透析 ； 高血磷 ； 磷 ； hemodialysis ； hyperphosphatemia ； phosphoric
|Volume or Term/Year and Month of Publication||
1卷2期（2002 / 12 / 01）
121 - 132
The purpose of this project was to reduce the high phosphoric value (over 6.0mg/dl) in long-term hemodialysis patients through quality control circle (QCC) activity. We attempted to reduce dialysis patients phosphoric values and to establish the standard of care for keeping dialysis patients under the normal phosphoric value. The first step was to identify dialysis patients with high phosphoric values (over 6.0mg/dl) by checking the biochemical test report. Next, these patients were interviewed and related data was analyzed. Finally, major factors which caused the high phosphoric values were analyzed and related improvement methodology was established. The major causes of high phosphoric values were found to be ”eating out at restaurants” and inadequate (low) dose of phosphate-binding drugs. Consequently, we emphasized these two factors as the key for solving this problem. The major methods for improving patient phosphoric values included having patients keep a dietary diary, using nursing checklists, offering portable medication boxes, making a mixture of powdered drugs and food, sending attractive patient reminder cards about medication compliance, and providing patients with nutrition plans using low phosphoric value foods. After implementing the above improvement methods in the hemodialysis unit for four months, the ratio of high phosphoric value (＞6.0mg/dl) patients was reduced from 30.4% in April 2002, to 18.6% in August 2002. This represents a reduction in the percentage of patients with high phosphoric values in this unit of 38.8%. Through using a quality control circle (QCC), phosphoric values of dialysis patients was successfully controlled, and the possibility of related bone syndrome was reduced.
醫藥衛生 > 社會醫學