提升骨科病房開放性傷口病人營養照護成效專案

Improve the Effectiveness of Nutritional Care for Patients with Open Wound in Orthopedics Wards

背景：開放性傷口病人在住院治療過程中因傷口組織缺損過大導致營養流失，容易有營養攝取不足而影響傷口癒合。術後營養攝取是病人能否早日恢復健康的關鍵，臨床發現開放性傷口病人每日熱量攝取足夠比率僅20.0%、住院中體重減輕>5%高達50.0%。
目的：提升開放性傷口病人營養照護成效，為每日熱量攝取足夠比率從20.0%提升至36.0%、體重減輕小於5%比率從50.0%提升至90.0%。
解決方法：製作營養照護手冊、設計促進傷口癒合新煮義食譜、製作飲食衛教海報及多媒體影音檔、彙整商店街食物並標示營養素及熱量、將飲食衛教納入病房團體衛教。
結果：病人每日攝取熱量從20.0%上升至83.4%、體重減輕小於5%比率從50.0%提升至91.7%。
結論：建議其他相關單位持續落實營養評估並定期監測，藉跨團隊合作模式共同評估病人的營養照護需求，設計合適之營養照護計畫提供正確營養認知，有助於改善住院病人營養不良狀況，以提高照護品質。

Background: Patients with open wounds may experience significant nutrient loss due to excessive tissue defects, which can lead to insufficient nutrient intake during hospitalization. This insufficient intake negatively impacts the wound healing process. Postoperative nutrition is crucial for a patient’s early recovery. Clinically, it has been found that only 20.0% of patients with open wounds achieve adequate daily calorie intake, while 50.0% of patients experience more than a 5% weight loss during hospitalization.
Purpose: The goal is to increase the proportion of patients with open wounds who achieve sufficient daily calorie intake from 20.0% to 36.0%, and to reduce the rate of weight loss 5% increased from 50.0% to 90.0%.
Solutions: A nutrition care manual was created, and healthy diets promoting wound healing were designed. Additionally, posters, videos, and audio files on dietary hygiene education were produced, and food nutrition and calorie labels were displayed in the hospital canteen. Dietary hygiene education was also incorporated into hospital ward routines.
Results: The proportion of patients achieving sufficient daily calorie intake increased from 20.0% to 83.4%, while the rate of weight loss < 5% increased from 50.0% to 91.7%.
Conclusion: This project recommends that relevant departments continue to implement regular nutritional assessments and monitoring. An interdisciplinary approach should be used to evaluate the nutritional needs of patients and design appropriate health plans. Raising awareness of nutritional support strategies will help improve malnutrition status among inpatients and enhance overall care quality.