题名

提升病嬰室由口餵食困難早產兒之全口餵食率

并列篇名

Increasing the Full Oral Feeding Rate of Premature Infants With Oral Feeding Difficulty

DOI

10.6142/VGHN.202109_38(3).0010

作者

林慧英(Hui-Ying Lin);林雅惠(Ya-Hui Lin);林欣怡(Hsin-Yi Lin);王筱華(Sheau-Hwa Wang)

关键词

早產兒 ; 餵食困難 ; 全口餵食率 ; premature ; difficult oral feeding ; full oral feeding rate

期刊名称

榮總護理

卷期/出版年月

38卷3期(2021 / 09 / 01)

页次

312 - 321

内容语文

繁體中文

中文摘要

在病嬰室的早產兒「由口餵食困難」問題若獲得改善,可以盡早脫離胃管及出院返家,符合家屬期待,又能減少醫療支出。本專案旨在提升病嬰室由口餵食困難早產兒之全口餵食率,滿足口慾及營養需求。經分析原因有:護理師對早產兒由口餵食困難認知不足、早產兒進食吸吮吞嚥不協調、餵食工具材質及孔洞大小不合適,及口腔胃管影響餵食等因素。經由舉辦在職教育、實施早產兒口腔餵食介入措施、應用定步餵食技巧、提供早產兒餵食工具多樣選擇性,和調整胃管放置位置的策略。由口餵食困難早產兒之全口餵食率由20.9%提升至68.7%,強化護理師餵食早產兒的信心、建立團隊合作模式,促進親子互動,持續朝高品質的早產兒照護目標邁進。

英文摘要

Addressing oral feeding difficulty in premature infants would reduce the time in which infants require a nasal gastric tube and the length of stay. This is not only satisfactory to parents but also reduces medical expenditures. The purpose of this project was to increase the full oral feeding rate of premature infants with oral feeding difficulty. The results indicated that the causes of the problem include insufficient knowledge and skill among caregivers, lack of coordination in suck- swallow pattern among premature infants when feeding, inappropriate pacifier texture and hole sizes, and interference with oral-gastric tube placement when feeding. Through caregiver education, premature oral training, the application of paced rhythm feeding technique, increasing selection of feeding tools, and establishment of the convention of placing the gastric tube through the nose, the full oral feeding rate increased from 20.9% to 68.7%. The results indicated that the project not only strengthened nurses' self-confidence but also promoted communication and harmony between teams. It further achieved the goal of high-quality care for preterm infants.

主题分类 醫藥衛生 > 預防保健與衛生學
醫藥衛生 > 社會醫學
参考文献
  1. American Academy of Pediatrics(2008).Hospital discharge of the high-risk neonate.Pediatrics,122(5),1119-1126.
  2. Bilyk, I., Fedorowicz, Z., Barron, S. A. (2019). Feeding the premature infant. DynaMed. Retrieved March 19, 2020 from https://www.dynamed.com/management/feeding-the-premature-infant/
  3. Christian, B. J.(2013).Translational research-the value of new evidence for improving the quality of pediatric nursing practice.Journal of Pediatric Nursing,28(4),411-412.
  4. Constanzaa, A. P.,Anab, G. M.,Marianaf, R. P.,Maríab, S. S.,Mónicab, V. Z.,Luisd, B. M.(2019).Standardization of early feeding skills (EFS) scale in preterm infants.Revista Chilena de Pediatría,90(5),508-514.
  5. Edwards, S.,Davis, A. M.,Bruce, A.,Mousa, H.,Lyman, B.,Cocjin, J.,Dean, K.,Ernst, L.,Almadhoun., O.,Hyman, P.(2016).Caring for tube-fed children: A review of management, tube weaning, and emotional considerations.Journal of Parenteral and Enteral Nutrition,40(5),616-622.
  6. Howe, T. H.,Hsu, C. H.,Tsai, M. W.(2010).Prevalence of feeding related issues/difficulties in Taiwanese children with history of prematurity, 2003-2006.Research in Developmental Disabilities,31(2),510-516.
  7. Kucharczk, S. D. (2015, Oct 24). Best Feeding.https://www.youtube.com/ watch?v=TuZXD1hIW8Q
  8. Law-Morstatt, L.,Judd, D. M.,Snyder, P.,Baier, R. J.,Dhanireddy, R.(2003).Pacing as a treatment technique for transitional sucking patterns.Journal of Perinatology,23(6),483-488.
  9. Majoli, M.,Artuso, I.,Serveli, S.,Panella, M.,Calevo, M. G.,Antonio, R. L.(2019).A key developmental step for preterm babies: Achievement of full oral feeding.The Journal of Maternal-Fetal & Neonatal Medicine,34(4),519-525.
  10. Shaker, C. S.(2013).Cue-based feeding in the NICU: Using the infant's communication as a guide.Neonatal Network,32(6),404-408.
  11. Thomas, J. A.(2007).Guidelines for bottle feeding your premature baby.Advances in Neonatal Care,7(6),311-318.
  12. Younesian, S.,Yadegari, F.,Soleimani, F.(2015).Impact of oral sensory motor stimulation on feeding performance, length of hospital stay, and weight gain of preterm infants in NICU.Iranian Red Crescent Medical Journal,17(7),e13515.
  13. 王淯汶,張瑩如(2013)。早產兒需求性餵食之實證探討。榮總護理,30(4),417-424。
  14. 何淑麗,賴麗珠(2007)。提升護理人員之新生兒照護指導完整率。嘉基護理,7(1),8-19。
  15. 林貞秀,張瑩如,林佳霓,黃美智(2012)。發展性照護於早產兒餵食之應用。護理雜誌,59(3),107-112。
  16. 張雅雯,張瑩如(2008)。早產兒口腔餵食與心肺功能調節。護理雜誌,55(3),5-10。
  17. 彭君怡,林麗鳳(2011)。早產兒口腔餵食介入措施之實證照護指引。長庚護理,22(2),175-183。
  18. 黃希文,陳佩珊,鄭素芳,王儷穎(2008)。早產兒餵食困難之評估與介入。物理治療,33(3),188-196。