提升某醫學中心出生32週以下早產兒全口餵食比率

Increasing the Oral Feeding Rate of Premature Infants Under 32 Weeks of Gestational Age in a Medical Center

10.6142/VGHN.202303_40(1).0005

余培筠(Pei-Yun Yu)；許瑀倢(Yu-Chieh Hsu)；蘇珮君(Pei-Jun Su)；游雅蘭(Ya-Lan Yu)

早產兒 ； 餵食過渡期 ； 餵食困難 ； premature infant ； feeding transition period ； feeding difficulty

榮總護理

40卷1期（2023 / 03 / 01）

51 - 58

繁體中文;英文

早產兒由於大腦、神經、肌肉控制尚未發展成熟，加上醫療處置的刺激常導致口腔過度敏感，延遲早產兒發展吸吮、吞嚥及反射機會，通常於32至34週才漸趨成熟，故此期為介入口腔餵食訓練的最佳時機，統計本單位2019年出生32週以下早產兒，於矯齡34+3週達全口餵食僅有50%，且同仁對全口餵食轉換過程多採被動等待，加上困難餵食常耗費護理時數，致醫護間常因認知差異而關係緊張，因而引發成立專案動機，本旨為提升出生32週以下早產兒全口餵食比率，經現況分析後歸納原因一、醫護人員認為進食為自然發展不需訓練而直接灌食；二、由口餵食時機不一致；三、早產兒吸吮吞嚥協調性差；四、早產兒吸吮耐力不足，經舉辦課程、擬定流程、制定復健方法及採購奶嘴後，出生32週以下早產兒全口餵食比率由50%提升至100%，建議其他醫院亦能訂定早產兒餵食標準作業流程，使早產兒能盡快達到全口餵食，提升照護品質。

In terms of the development of sucking, swallowing, and reflexes, the optimal time for intervention in oral feeding training for premature infants is when they reach 32-34 weeks. However, only 50% of the premature infants under 32 weeks of gestational age born at the unit in 2019 achieved oral feeding at 34^(+3) weeks of corrected age. The attitude of nursing staff toward the process of converting premature infants to oral feeding is often passive. In addition, feeding premature infants is time consuming, and the relationship between physicians and nurses is typically not harmonious due to cognitive differences. This study aimed to improve the success rate of oral feeding in premature infants under 32 weeks of gestational age. After the current situation was analyzed, the following causes were identified: (1) oral feeding being a natural developmental process that does not require training; (2) inconsistent timing of oral feeding; (3) poor coordination of sucking and swallowing in premature infants; and (4) insufficient sucking endurance in premature infants. After holding courses, developing procedures, establishing rehabilitation methods, and purchasing pacifiers, the researchers increased the oral feeding rate of premature infants under 32 weeks of gestational age from 50% to 100%. Other hospitals should develop standardized protocols for the oral feeding of premature infants to promote earlier oral feeding for increased quality of care.

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