一位重症病患營養需求代言的護理經驗

A Case Study of Advocating Nutritional Support for a Critical Care Patient

本個案報告主要描述護理人員，為一位重症病患營養需求代言的護理經驗。於護理期間以主護護士的角色，完成 23 篇照護日誌，將收集所得資料分析、整理，結果發現個案有嚴重營養需求被忽略的問題。針對這個問題，主護利用本身的敏感度，配合運用身體評估、磋商、溝通的技巧，且與護理人員、營養師、會診醫師及家屬建立社交網路關係，藉由代言的方式，於照護之第二週開始為個案爭取到其所需之腸道及靜脈營養；使個案壓瘡傷口癒合，精神、抵抗力、肌肉力量逐漸改善，白蛋白值逐漸提升，且順利脫離呼吸器轉出加護病房。A case study described a nursing experience experienceadvocating nutritional support for a critical care patient. Data were collectedusing physical assessment, record analysis and family interviews. A total of 23patient diaries were written in the period from 1990 March 1 to 1990 April 28.Content analysis revealed that patient had severe nutritional deficits withoutmedical attention. The primary nurse, who identified the problem, usedstrategies to develop a support network consisting of consulting doctors, dieticians and nursing colleagues to request sufficient enteral and parenteralnutritional support for patient. Positive outcomes included wound healing, entilator weaning and discharge from the intensive care unit. Results of thisstudy demonstrated that advocacy is a role of the nursing profession.