降低胃癌病人空腸造瘻管阻塞率

The Reduce of Obstruction Rate in Gastric Cancer Patients with Jejunostomy

10.6692/KJN.202005/SP_37.0004

曾斐祺(Fei-Chi Tseng)；蘇毓婷(Yu-Ting Su)；劉云溱(Yun-Jhen Liu)

胃癌 ； 空腸造瘻管 ； 阻塞率 ； gastric cancer ； jejunostomy tube ； obstruction rate

高雄護理雜誌

37卷增訂刊（2020 / 05 / 01）

37 - 47

繁體中文

胃癌病人伴隨進食、用藥困難與營養不良等問題，需經由空腸造瘻管提供營養及藥物攝取功能，一旦發生管路阻塞無法執行功能時，易影響營養攝取及用藥安全。統計本單位2016年1月至8月間胃癌病人照顧者執行空腸造瘻管阻塞率高達24%，導致病人營養失調及無法用藥故引發此專案動機。本專案目的為降低空腸造瘻管阻塞率至4.8%，執行期間為2016年10月1日至2017年5月31日，經由舉辦在職教育課程、運用灌藥及灌食準則、使用護理指導衛教單張、執行護理臨床指導路徑，並依審核表進行稽核措施等介入處置，結果呈現胃癌病人空腸造瘻管阻塞率由24%降至0%，達到專案改善目的，使其正確及安全執行空腸造瘻管灌食及灌藥功能。

Due to eating problems, drug administration difficulties and malnutrition, patients with gastric cancer often require jejunostomy to support enteral nutrition and medication; therefore, nutritional intake and safe medication are easily compromised upon jejunostomy obstruction. According to our statistics, the obstruction rate of jejunostomy among gastric cancer patients in our department from January to August 2016 was up to 24%. The resulting malnutrition and difficulties in drug administration motivated us to formulate corresponding solutions. To reduce the obstruction rate to 4.8%, a project with several interventions (including on-the-job training, the development of jejunostomy tube feeding guidelines, the preparation of patient education and materials, clinical pathways, audition per checklist, etc.) was implemented from October 1, 2016 to May 31, 2017. The results showed that the incidence of jejunostomy obstruction was completely eliminated (from 24% to 0%), suggesting that the interventional project was effective and helpful to meet the goal of accurate and safe tube feeding.