降低血液透析病人血清白蛋白異常率之專案

Project to Decrease the Incidence of Hypoalbuminemia in Dialysis Patients

透析病人的血清白蛋白值是重要的營養指標，與病人死亡率有密切相關。故本專案目的在於降低透析病人血清白蛋白之異常率。統計本單位 2010 年 7 月至 12 月份透析病人血清白蛋白異常者有 28 位，佔 17.5％，分析原因有：缺乏衛教輔助工具、缺乏衛教指導流程、病人及主要照顧者缺乏營養認知、缺乏飲食日誌和未安排在職教育訓練等問題。依原因研擬對策為：製作白蛋白飲食衛教單張、建立白蛋白飲食衛教指導流程、製作飲食日誌、成立居家訪視小組、規劃護理人員在職教育訓練。實施後，血清白蛋白異常率由 17.5％降至 8.0％。本結果不僅改善透析病人血清白蛋白異常率，提升病人和家屬對營養攝取認知，更提升本單位對血液透析病人照護之品質。

Serum albumin values of dialysis patients are important indicators of nutrition and closely associated with patient mortality. The purpose of the project is to reduce the incidence rate of hypoalbuminemia in dialysis patients. The data was collected between July and December in 2010. The total number of hypoalbuminemia patients was 28 (17.5%). Analysis of the causes of hypoalbuminemia revealed the following: lack of health education aids, lack of guidance on health education, lack of nutrition awareness among patients and primary caregivers, lack of diet logs and failure to arrange for in-service education. The following initiatives were set up in response: dietary health education pamphlets on albumin were produced, guidelines on albumin diet and health education were defined, diet logs were produced, a home visit team was organized, and in-service training developed for nursing staff. Once the initiatives were introduced, the incidence of hypoalbuminemia decreased from 17.5% to 8.0%. This outcome not only to improved the incidence of hypoalbuminemia among dialysis patients but also boosted awareness of nutrition support among hemodialysis patients and their families. Finally, it improved the quality of health care for hemodialysis patients at our unit.