改善血液透析病人血清白蛋白低下之發生率

The Adjustment on the Effectiveness of Low Serum Albumin in Patients with Hemodialysis

低血清白蛋白與死亡率有密切關係。統計2015 年1-8 月病人血清白蛋白＜3.5 g/dL 發生率達26％，分析原因為病人缺乏對白蛋白知識認知及不知蛋白質食物種類與份量、護理人員與主要照顧者缺少溝通平台及對營養飲食的新知缺乏、護理指導工具不符病人需求及照護標準規範未更新。專案旨在改善透析病人血清白蛋白低下之發生率，經小組擬定對策：修訂照護標準規範、規劃人員在職教育、修改衛教單張、製作圖片、大型海報與溝通手冊、舉辦團體衛教於2015 年9 月1 日至2016 年8 月31 日執行，結果顯示病人血清白蛋白＜3.5 g/dL 發生率降至9.4％，達專案目標。專案能成效維持，不僅改善病人蛋白質營養不良，也提升照護品質。

 

Low serum albumin is closely related to mortality. According to the data from January to August, 2015, the incidence of the patients’ serum albumin < 3.5 g/dL was 26%. The reasons why these people have low serum albumin may be contributed to (1) lack of albumin knowledge, (2) unawareness of the food types containing protein, (3) lack of communication platform for the nursing staff and caregiver for sharing dietary nutrition information, (4) teaching tools not meeting the patients’ requirement, and (5) the care standards are out of date. The aim of our project team is improving serum albumin level. The team developed countermeasures, such as: (1) Revised standards for care, (2) Vocational education, (3) Revised educational leaflets, (4) Graphical productions, (5) Formulating posters and communication manuals, and (6) Group education. These methods were carried out from September 1, 2015 to August 31, 2016. The incidence of low serum albumin (< 3.5 g/dL) was reduced to 9.4%, meeting the target of this project. The maintenance of the project not only improved the patients’ protein-malnutrition, but also enhanced the quality of care.