提升長期血液透析病人護理指導完整性方案

Promoting the Integrity of Nursing Instruction for Hemodialysis Patients

目前，台灣地區長期透析人口，以血液透析人數佔最多。長期血液透析病人常產生許多不適症狀與合併症，不僅影響生活品質，更是造成病情惡化致死的重要指標。由於本單位護理指導滿意度調查僅54.3%，為增進病人自我照顧的知識與技巧及護理指導滿意度，故實施本專案。在過程中建立了長期血液透析病人的護理指導標準，來提昇單位護理指導完整性與服務品質。於2005年7月至2006年4月，制定護理指導標準手冊、自學光碟，並對單位中173位長期血液透析病人進行個別護理指導。結果：護理指導完整性由58%提昇至91%，病人對護理指導滿意度由54.3%提昇至83%，達到本專案目標。專案實施期間，成功得到單位導管與病人的支持與肯定，目前仍持續進行，更期望能推廣至病房單位與透析醫療相關機構。

Most dialysis patients in Taiwan are hemodialysis patients. Long term hemodialysis will cause many side effects and complications which a not only affect patients' life quality but also are important indexes related to causation of death. A survey of the satisfaction rate of nursing instruction for the hemodialysis in our unit only reached 54.3%; therefore, this project aims to improve the knowledge and skill of patient's self care and to increase patient's satisfaction concerning our nursing instruction. We developed nursing guideline for long term hemodialysis patient to upgrade our service quality and complete our nursing guidelines. From July 2005 to April 2006, we published a nursing guideline hand book, and self-study VCDs. We also provided personal instruction to 173 long term hemodialysis patients from our unit. Results: the integrity of nursing instruction increased from 58% to 91%. The patient’s satisfaction rate increased from 54.3% to 83%; both of these reached the goal of this project. During the time of our project, we received wide support from our patients and supervisors. Even though our project is finished, we continue to use this guideline and hope to extend it to every relevant department and hospital.