降低血液透析病患血清白蛋白不正常率之方案

The Project for Lowing Abnormal Rate of Serum Albumin with Hemodialysis Patients

長期透析患者因蛋白質及熱量攝取不足，而有血清白蛋白降低的問題。根據本單位成員於2008年9月發現124位常規透析病患，血清中白蛋白低於3.5g/d l佔25%，故本專案目的為降低透析病患血清白蛋白不正常率，經現況分析後發現導因包括：護理人員缺乏蛋白質份數評估表，病患對於高蛋白飲食種類及攝取份數不清楚，與病患攝取高蛋白不足。針對導因施行改善策略包括：制定血清白蛋白改善計畫單及蛋白質份數評估表、製作國、台、客語版高蛋白質衛教宣導影片、高蛋白飲食衛教單張及海報等措施。結果發現：白蛋白低於3.5g/dl病患之比率由25%降至8.4%，達成此專案目標。顯示本專案能正確評估病患白蛋白偏低之原因，並給予衛教改善，以提升病患營養狀態，減少其合併症發生。

Because of an inadequate intake of protein and calories, patients on long term dialysis often have low serum albumin. At the beginning of this project in September 2008, there were 124 patients on regular dialysis. Thirty one of these patients (25%) had low serum albumin (<3.5g/dl). Data analysis showed that there were three factors associated with low albumin: nursing staff lacked an assessment tool, patients did not know what type and amount of high protein they should ingest, and patient did not take in sufficient protein. The strategies for this project included development of an assessment tool preparation of a plan to improve albumin levels, and production in three languages (Chinese, Taiwanese, and Hakka) of a film, pamphlet and poster about the need for higher protein intake. The results showed that the rate of low albumin decreased from 25% to 8.4%.This project correctly assessed the factors related to low albumin and provided health education to improve nutritional status and decrease the complications from hemodialysis.