英文摘要 |
Blood vascular access is viewed as a second life to a patient with hemodialysis. Therefore, it is especially vital to keep the blood vascular access open for patients who need to puncture blood vessels prior to each hemodialysis, that is, three times every week. The occurrences of blood vascular access abnormalities such as occlusion, bleeding, or narrowing of blood vessels are not only troublesome to the patient and family and time-consuming for the medical professionals to repair, but also affects the effectiveness of hemodialysis and the patient's quality of life. The abnormalities could also lead to a life-threatening situation impacting the hospital's quality of care and the patient's safety. A project team was established with the intention of reducing the occurrence of blood vascular access abnormalities. The patients regularly receiving hemodialysis between July 1 to December 3, 2008, were examined, and the medical records of patients who received hemodialysis between January to June, 2008 were reviewed. During this period of time, the total number of hemodialysis performed was 19,885, and the number of occurrences of blood vascular access abnormalities was 101, i.e. 5.1% occurrence rate. The strategies to solve the problems regarding blood vessel access abnormalities included the provision of patient education with accurate information on nursing interventions and infection control. The monitoring forms were adopted to ensure that the nurses follow the care standards in providing patient education and completing nursing documentation during hemodialysis, and to teach patients hemodialysis-related care skills. With the implementation of the above strategies, the occurrence rate of blood vascular access abnormalities dramatically dropped to 2%, quality of nursing care was promoted, and patients' quality of life was improved. |