提升養護機構住民管灌營養照護成果之改善專案

A Project to Improve Nutritional Status for Tube-Fed Residents in a Long-term Care Facility

因家庭結構改變，照顧殘病老人的責任已漸漸由家庭轉移到長期養護機構，但住民的營養狀況卻一直是照護的問題。經分析所服務之養護機構後，發現大部份住民有營養不良問題，其原因為（1）照顧人員對住民的營養認知不足，只有48.6分，（2）缺乏個別化之營養配方，（3）管灌餵食的操作流程未標準化及（4）未定期監測等。經實施人員教育訓練、邀請營養師的實際教導食物之製作、訂定管灌的標準及建立定期營養監測等措施後，人員對住民的營養認知提升至平均70分；而住民之平均血清白蛋白亦由實施前之3.5g/dl提升至實施後3.7g/dl，達專案目的。同時，定期監測住民體重的機制亦從2004年5月開始落實至今。本專案之實施除能改善住民之營養狀況外，亦提升機構中工作人員對住民營養之重視。With changes in family structure, the burden of care for fragile elders is now being transferred from family to long-term care facilities. However, nutrition among elderly residents is an ongoing care problem. According to current data analysis, reasons related to malnutrition among elderly residents were 1).Providers had inadequate knowledge, at only 48.6 points, and received no education training. 2).Nutrition formulas were not individualized. 3).Tube feeding procedures were not standardized. 4).Nutritional status was not monitored regularly. After implementing 1) an educational training program, 2) inviting a nutritionist to participate in this project, 3) developing tube feeding procedure standards, and 4) establishing a regular nutritional status monitoring, the knowledge level of providers increased to an average of 70 points and the mean of albumin increased from 3.5g/dl to 3.7g/dl. The aims of this project were achieved. Meanwhile, since the establishment of monitoring system in May of 2005, this project has not only increases the nutritional status of fragile residents, but has also improved the awareness of providers in looking after residents' nutrition.