降低血液透析過程中病患血壓下降之專案

A Project to Reduce Blood Pressure Drop for Dialysis Patients with Hemodialysis

本專案主旨在降低病患於透析過程中血壓下降的發生率。血壓下降大多發生於結束透析之前一個小時，而此時間乃是單位較忙碌的時刻，且因護理人員的工作經驗及專業能力不足等原因而無法有效預防及處理血壓下降的發生，導致病患的生命安全受到威脅。經分析發現問題為:1.病患水分控制不佳2.病患使用降血糖藥物時間錯誤3.護理人員的工作經驗不足導致專業能力較弱4.護理人員無統一的標準程序可遵循。故成立專案小組，教導病患水分控制方法；便利藥盒的使用，並加強護理人員的在職教育及制定預防低血壓之照護標準流程，來改善低血壓的發生。經由此專案的實施，血壓下降發生率由改善前16.2%降至改善後5.0%，相對的減少了病患合併症的發生。

The study is aimed at reducing the occurring rate of blood pressure in the process of hemodialysis. In general, blood pressure is reduced one hour prior to the ending of the hemodialysis. Unfortunately, this time is often the busiest period in the hospital. Due to a lack of work experience and professional capability on the part of nursing staff, reduced blood pressure cannot be efficiently prevented and patients are facing a life-threatening situation. After analysis, the researcher concluded:1. The moisture control in patients’ bodies is bad; 2. the timing is wrong in taking the medicine for countering reduced blood pressure; 3. due to a lack of work experience, nursing staff’s professional capability is weak, and 4. no unified standard process is being followed. A professional team has to be established in order to teach patients the method of controlling the moisture in their bodies; using the convenient medicine box, so that the right timing for taking medicine can be properly carried out; strengthening on the job training for nursing staff, and establishing a standard process of preventing the dropping of blood pressure in order to reduce the occurrence of low blood pressure. After conducting the method mentioned in this study, the occurrence rate of low blood pressure dropped from 16.2% to 5.0%. As a result, related complications were decreased.