提升長期血液透析病人水份控制合格率之專案

Improving Success Rates of Fluid Control in Patients Undergoing Long-term Hemodialysis

10.6740/NTUHJN.202101_17(1).0016

歐春鷰(Chun-Yen Ou)；謝易玲(Yi-Ling Shie)；黃小倩(Hsiau-Chien Hwang)

血液透析 ； 水份控制 ； 乾體重 ； 應用程式 ； 兩次透析間體重增加 ； hemodialysis ； fluid control ； dry weight ； application ； App ； interdialytic weight gain (IDWG)

臺大護理雜誌

17卷1期（2021 / 01 / 01）

183 - 195

繁體中文

背景：血液透析病人於兩次透析間體重增加應控制在乾體重5％以下，以預防透析脫水率過快造成的併發症。目的：提升長期血液透析病人兩次透析間，體重增加小於5％乾體重之比率。解決方案：舉辦護理師在職教育、修訂衛教單張、製作衛教大海報、發展多媒體衛教模具、推廣體重控制及營養成份應用程式（application, APP）、舉辦闖關活動、以及實施獎勵制度（達到體重自主管理者可參加摸彩活動）等。結果：專案實施後，每月透析間體重增加小於5％乾體重人次比率由2017年9月的82.4％上升至2018年9月的92.0％，已達設定目標90.5％。結論：本專案有助於提升病人自我效能以利行為改變，建議未來針對不同階段病人設計不同衛教介入措施，以協助做好水份控制及行為改變；冀本專案之經驗可作為其他透析護理之參考。

Background: In patients undergoing regular hemodialysis, body weight gain between dialysis sessions should be controlled within 5% of dry weight to prevent a high ultrafiltration rate (UFR) and its associated complications. Purpose: This study is aimed to evaluate the effects of an integrated project to increase the success rates of fluid control in patients undergoing long-term hemodialysis. Methods: The project included providing in-service education, revising the health education leaflet, making the health education poster, developing multimedia health education tool, promoting weight control and nutrition applications (APP), holding breakout events, and implementing incentive rewards (patients who reach weight control goals can participate in lottery activities). Results: After interventions, the proportion of patients with successfully controlled intradialytic weight gain less than 5% of dry weight increased from 82.4% to 92%. The results reached the target of 90.5%. Conclusions: This project helps to improve patient self-efficacy for behavioural change and recommends that different health interventions be designed for patients at different stages in the future to assist in fluid control and behavioural change. This project can be used as a reference for dialysis care in other institutes.

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