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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符合標準比率之改善專案
卷期 15:2
並列篇名 Improving the Hemoglobin Conformity Rate Among Peritoneal Dialysis Patients
作者 張簡綉雯闕淑能黃小倩
頁次 039-052
關鍵字 貧血鐵質缺乏治療流程腹膜透析anemiairon-deficiencytreatment protocolperitoneal dialysisTSCI
出刊日期 201606
DOI 10.3966/172674042016061502004

中文摘要

本專案主要目的為提升腹膜透析病人血色素符合標準比率。本腹膜透析中心統計 2012 年 3 月平均血色素僅為 8.7 g/dL,病人血色素達美國食品管理局(FDA)建議 標準≧10 g/dL 以上,僅約佔 49.1%。專案小組為提升腹膜透析病人血色素,分析主 要原因為:缺乏腹膜透析病人貧血治療流程和鐵劑建議使用規範、鐵劑使用的遵從性 低、慢性出血、血中白蛋白質不足、紅血球生成素的作用認知錯誤、未按時注射紅血 球生成素。專案小組提出改善方案如下:(1)定期舉辦透析病人改善貧血團體護理 指導(2)制訂鐵劑建議使用規範(3)制訂腹膜透析病人貧血治療和轉介流程。方案 執行 4 個月後,腹膜透析病人平均血色素由 8.7 g/dL 提升至 10.2 g/dL,達標準比率 佔 65.3%,達到本專案目標值 10 g/dL 以上,顯示本專案有具體成效。

英文摘要

This project aims to improve the percentage of peritoneal dialysis (PD) patients with hemoglobin levels that conform to institutional standards. In our PD center, only 49.1% of patients had hemoglobin levels ≧ 10 g/dL and the average hemoglobin levels was only 8.7 g/dL, which lower than the value of 10 ~ 11 g/dL recommended by the U.S. Food and Drug Administration (FDA). We speculated that the main reasons of low hemoglobin level included iron deficiency, low consumption of high-iron content foods due to a lack of knowledge, chronic bleeding without treatment, and inadequate protein intake. This program therefore sought to improve anemia in PD patients through the following measures: (1) holding regular group education sessions; (2) developing a set of recommendations on iron supplements; (3) development of a treatment protocol for anemia. Four months after the program was implemented, the average hemoglobin levels of our PD patients increased from 8.7 g/dL to 10.2 g/dL, and 65.3% of the PD population reached our original target of 10 g/ dL or higher. In conclusion, this anemia-improving project showed positive and encouraging results, and merits further investigation.

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