運用吞嚥訓練協助一位氣管造口術病人由口進食之護理經驗

Nursing Experience of Swallowing Training for a Tracheostomized Patient

本文分享如何運用有計畫的護理措施，協助一位住呼吸照護中心之氣管造口術病人，順利由口進食，移除鼻胃管的照護經驗。筆者在13天的照護期間，以直接護理、觀察及身體檢查評估，並與家屬深入會談進行資料收集，確立其主要照護問題為吞嚥障礙併高危險性肺吸入及影響進食意願之活動無耐力；筆者運用主動關懷，提供家屬吞嚥訓練的知識，幫助病人有計畫的在住院期間接受吞嚥訓練，使其可由口安全進食軟質飲食滿足口慾，成功移除已留置二年的鼻胃管。由此照護經驗發現，經由仔細評估吞嚥能力並介入有計畫的護理活動，即使是有氣管造口術的病人，仍有機會重拾由口進食的模式，提升病人的生活品質。

This case report illustrated nursing experience of swallowing training for a tracheostomized patient placed on a respiratory ward. Primary nurse assessed patient's swallowing ability and initiated individualized training course. She has been under the care for thirteen days, during which she received sessions of planned swallowing training. Through cooperation of families, patient regained her swallowing ability and could eat food safely. The nasogastric tube which had been placed for more than two years was finally removed. The presentation of this successful nursing experience would help other nurses for caring similar patients in the future.