提升護理人員執行口腔癌病人化療期間之營養篩檢正確率

Improving The Accuracy of Nutrition Screening Tests Performed by Nursing Professionals for Oral Cancer Patients During Chemotherapy

本專案目的在提升護理人員執行口腔癌病人化療期間之營養篩檢正確率，及早發現病人營養不良狀況，轉介營養師提供指導，減少疾病合併症。於2016年10月3日至20日經營養篩檢查檢表檢核護理人員營養篩檢正確率僅66.7%，引發專案動機。運用問卷及查閱病歷主要問題：護理人員營養篩檢認知不足、未定期舉辦營養篩檢再訓練、篩檢內容複雜、體重資料收集不易。解決辦法包括：簡化營養篩檢工具，增加體重自動帶入與流失試算、舉辦在職教育及床邊教學、定期監測營養篩檢。實施後營養篩檢正確率提升至85.7%，達專案目的；簡化營養篩檢內容及修改資訊系統，護理人員能正確營養篩檢及掌握病人體重變化，適當轉介營養師，進而降低體重流失率。

The purpose of this project is to improve the accuracy of nutritional screening tests performed by nursing staff for oral cancer patients during chemotherapy, early detect malnutrition in patients, refer to dietitians for guidance, and reduce disease comorbidities. From October 3 to 20, 2016, the accuracy rate of nutrition screening performed by the nursing staff was only 66.7%, which triggered the motivation of the project. After analyzing questionnaires and reviewing medical records, main problems were found, including nursing professionals being lack of cognition in nutrition screening, no regular retraining of nutrition screening, screening contents being too complicated, and difficulty in collecting weight data. Solutions include: simplifying nutritional screening tools, increasing automatic weight gain and loss trial calculation, holding on-the-job education and bedside teaching, and regularly monitoring nutritional screening. After implementation, the accuracy rate of nutrition screening is increased to 85.7% to achieve the purpose of the project. The nursing staff can correctly screen nutrition condition and control the patient's weight changes by simplifying the nutrition screening content and modifying the information system. The weight loss rate can be reduced by referring to the dietitian appropriately.