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臺灣腎臟護理學會雜誌

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篇名 提升腹膜透析病人血色素之改善專案
卷期 18:1
並列篇名 Improving the Hemoglobin in Peritoneal Dialysis Patients
作者 王郁薇周雪琦許薳尹
頁次 016-030
關鍵字 腹膜透析腎性貧血紅血球生成素peritoneal dialysisrenal anemiaerythropoietinTSCI
出刊日期 201906
DOI 10.3966/172674042019061801002

中文摘要

本專案目的旨在提升腹膜透析病人的血色素,以改善病人貧血。經統計本腹膜透析室 2015 年病人的檢驗結果,有 6 個月血色素值大於 8.5 g/dL 的比率未達 90%,低於醫院評鑑標準。專案小組經由現況分析得知問題導因為:營養不良、貧血衛教不足、病人未依醫囑施打紅血球生成素、鐵質缺乏以及血液流失等。透過跨團隊合作,文獻查證,提供高鐵高蛋白飲食衛教、貧血護理指導、制訂鐵劑補充作業規範並提供提示單、調整紅血球生成素劑型以提高注射遵從度。經專案改善後,連續追蹤 5 個月病人血色素值大於 8.5 g/dL 的比率均大於 90%,已達醫院評鑑優良標準,病人血色素平均值由 9.83 g/dL,提升至 10.01 g/dL。此專案經驗與改善方案,可作為腹膜透析護理人員有效提升病人血色素之重要參考。

英文摘要

The project aims to improve hemoglobin in peritoneal dialysis patients to improve anemia in patients. In our PD center, the ratio of hemoglobin values greater than 8.5 g/ dL for 6 months was less than 90% in 2015, which was lower than the hospital evaluation criteria. We analyzed that the main reasons of low hemoglobin level include: malnutrition, low consumption of high-iron content foods due to lack of knowledge, poor compliance on erythropoietin injections, iron deficiency, and blood loss etc. Cross-team cooperation, document verification, education on high-iron and high-protein diets, education on anemia care, formulation of iron supplement procedures and provide reminders and dosage adjustment for erythropoietin to improve compliance for injections were used for improvement. After improvement through the project, the rate of patients who were tracked continuously for five months with hemoglobin greater than 8.5 g/dL was over 90%. The experience and improvement program from this project can be used as an important reference for peritoneal dialysis nurses to effectively improve hemoglobin in patients.

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