提升高齡長者進食安全指導執行率

Improving the Rate of Eating Safety Guidance Implementation Among the Elderly

背景：有效的吞嚥評估及進食安全指導，可提升高齡長者進食安全，經現況分析發現高齡長者發生嗆咳後，導致吸入性肺炎比例高，護理人員對高齡長者進食安全指導執行率僅64.6％，歸納原因為未接受過高齡長者進食安全相關教育訓練、教導內容不一致，僅採口頭衛教指導、沒有統一的衛教內容及沒有適當衛教指導輔助工具。目的：護理人員對高齡長者進食安全指導執行率，由64.6％提升至90.0％。解決方案：經由跨團隊合作推展高齡長者進食安全指導作業流程、運用人體模型及食物模型、推行口腔保健及健口操、使用多元語言進食安全衛教指導單張及影片、推展樂齡長者進食安全尋寶趣~食物質地選擇圖卡、實施進食安全情境模擬工作坊。結果：經由專案實施改善後，護理人員對於高齡長者進食安全指導執行率，由64.6％提升至92.1％，表示介入措施的成效顯著。結論：藉由制訂照護流程及與跨團隊合作擬定具體可行之改善措施，以有效提升護理人員對高齡長者進食安全指導執行率。

Background & Problems: The provision by nurses of effective swallowing assessments and eating safety guidance improves eating safety in the elderly. The authors of this study found that elderly clients experienced a high proportion of aspiration pneumonia after choking episodes and that the rate of implementation of eating safety guidance among these clients by nursing staff was only 64.6%. The problems identified included a lack of education and training related to eating safety for the elderly, inconsistent health education methods, oral health education only, lack of unified health education content, and lack of proper health education guidance aids. Purpose: To raise the rate of implementing eating safety guidance among the elderly from 64.6% to 90.0%. Resolution: The project included promoting an eating safety guidance workflow for the elderly using cross-team collaboration, using human body models and food models, promoting oral healthcare and oral exercises, using multilingual instructional leaflets and videos on eating safety and hygiene education, promoting a treasure hunting activity to the elderly related to eating safely using a food texture selection chart, and implementing a workshop on simulated eating safety scenarios. Results: After project implementation, the eating safety guidance implementation rate increased from 64.6% to 92.1%, demonstrating that the intervention measures achieved remarkable results. Conclusion: Formulating care procedures and cooperating across teams to draft concrete and feasible improvement measures effectively increased the rate of eating safety guidance implementation for elderly clients by nursing staff.