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題名:提升重症病人72小時內腸道灌食理想熱量達成率之改善專案
書刊名:護理雜誌
作者:黃素芬楊琳琪邵學方許正義吳杏真
作者(外文):Huang, Su-fenYang, Lin-chiShao, Hseu-fangHsu, Jane-yiWu, Hsing-chen
出版日期:2014
卷期:61:2(附冊)
頁次:頁5-13
主題關鍵詞:重症病人腸胃道灌食理想熱量達成率Critical patientsEnteral nutritionIdeal caloric intake
原始連結:連回原系統網址new window
相關次數:
  • 被引用次數被引用次數:期刊(1) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:1
  • 共同引用共同引用:3
  • 點閱點閱:16
背景:早期提供重症病人腸道灌食並於72小時內達目標熱量之70%,可降低院內感染、住院天數與死亡率。本單位重症病人之理想熱量達成率較低(40.6%)。目的:透過專案的執行,使重症病人72小時內理想熱量達成率提升至70%。解決方案:(1)舉辦營養相關在職教育、(2)制定腸道灌食流程表、宣導並鼓勵執行腸道灌食流程表、(3)與醫師及營養師共同討論病人灌食狀況、(4)修訂重症病人鼻胃管灌食標準流程等。結果:理想熱量達成率由40.6%提升至74.3%。結論:此專案透過跨團隊合作,確實可提高重症病人之理想熱量達成率。可提供未來其他醫院改善重症病人理想熱量之參考,以改善醫療照護品質。
Background & Problems: Early enteral nutrition and receiving more than 70% of the ideal caloric intake level has been shown to reduce patient infection rates, duration of hospital stays, and mortality. Only 40.6% of patients in our surgical intensive care unit were achieving the ideal caloric intake level.Purpose: This project was designed to raise the ratio of those achieving an ideal caloric intake level from 40.6% to 70%.Resolutions: Strategies included: (1) providing education related to nutrition, (2) establishing an enteral nutrition flowchart and popularizing and carrying out the enteral nutrition flowchart, (3) discussing together with doctors and nutritionists about feeding conditions, and (4) revising standard procedures for the NG feeding of critical patients.Results: Seventy percent of patients in the surgical intensive care unit achieved their ideal caloric intake level after implementation of this intervention.Conclusions: This project used interdisciplinary cooperation to improve caloric intake among patients in the surgical intensive care unit. The intervention and results may be used as a reference by hospitals for improving patient caloric intake and hospital quality of care.
期刊論文
1.王義明、黃煜為、林姿伶、陳思穎(20090800)。重症病患的營養支持。中華民國重症醫學雜誌,10(3),229-241。  延伸查詢new window
2.翁敏雪(20070900)。重症病人的營養照護。長庚護理,18(3)=59,365-371。new window  延伸查詢new window
3.林晏如、陳玉如、葉玲岑、李靜怡、王秀媛(20110300)。早期腸道營養對內科重症老人預後之探討。中華民國重症醫學雜誌,12(1),1-8。  延伸查詢new window
4.Arabi, Y.、Haddad, S.、Sakkijha, M.、Shimemeri, A. A.(2004)。The impact of implementing an enteral tube feeding protocol on caloric and protein delivery in intensive card unit patients。Nutrition in Clinical Practice,19(5),523-530。  new window
5.陳玉枝(20090400)。Critical Analysis of the Factors Associated with Enteral Feeding in Preventing VAP : A Systematic Review。Journal of the Chinese Medical Association,72(4),171-178+CA33。  new window
6.Doig, G. S.、Heighes, P. T.、Simpson, F.、Sweetman, E. A.、Davies, A. R.(2009)。Early enteral nutrition, provided within 24 h of injury or intensive care unit admission, significantly reduces mortality in critically ill patients: A meta-analysis of randomised controlled trials。Intensive Care Medicine,35(12),2018-2027。  new window
7.Elpern, E. H.、Stutz, L.、Peterson, S.、Gurka, D. P.、Skipper, A.(2004)。Outcomes associated with enteral tube feedings in a medical intensive care unit。American Journal of Critical Care,13(3),221-227。  new window
8.Marshall, A. P.、Cahill, N. E.、Gramlich, L.、MacDonald, G.、Alberda, C.、Heyland, D. K.(2012)。Optimizing nutrition in intensive care units: Empowering critical care nurses to be effective agents of change。American Journal of Critical Care,21(3),186-194。  new window
9.Marshall, A. P.、West, S. H.(2006)。Enteral feeding in the critically ill: Are nursing practices contributing to hypocaloric feeding?。Intensive and Critical Care Nursing,22(2),95-105。  new window
10.Martindale, R. G.、McClave, S. A.、Vanek, V. W.、McCarthy, M.、Roberts, P.、Taylor, B.、A.S.P.E.N. Board of Directors(2009)。Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition: Executive summary。Critical Care Medicine,37(5),1757-1761。  new window
11.McClave, S. A.、Martindale, R. G.、Vanek, V. W.、McCarthy, M.、Roberts, P.、Taylor, B.、Ochoa, J. B.、Napolitano, L.、Cresci, G.、The A.S.P.E.N. Board of Directors、The American College of Critical Care Medicine(2009)。Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.PE.N)。Journal of Parenteral and Enteral Nutrition,33(3),277-316。  new window
12.Montejo, J. C.、Minambres, E.、Bordeje, L.、Mesejo, A.、Acosta, J.、Heras, A.、Manzanedo, R.(2010)。Gastric residual volume during enteral nutrition in ICU patients: The REGANE study。Intensive Care Medicine,36(8),1386-1393。  new window
13.Norman, K.、Pichard, C.、Lochs, H.、Pirlich, M.(2008)。Prognostic impact of disease-related malnutrition。Clinical Nutrition,27(1),5-15。  new window
14.Preiser, J. C.、Chiolero, R.、Wernerman, J.(2003)。Nutritional papers in ICU patients: What lies between the lines?。Intensive Care Medicine,29(2),156-166。  new window
15.Artinian, V.、Krayem, H.、DiGioyine, B.(2006)。Effects of early enteral feeding on the outcome of critically mechanically ventilated medical patients。Chest,129(4),960-967。  new window
會議論文
1.Barlow, R. C.、Price, P. E.、Lewis, W.、Puntis, M. C. A.(2010)。A randomised controlled trial of early enteral nutrition versus standard management for patients undergoing major resection for upper gastrointestinal malignancy - A comparison of costs198。  new window
圖書
1.萬芳醫院護理部(2010)。急重症病人腸道灌食臨床照護指引。台北市:台灣愛思唯爾。  延伸查詢new window
 
 
 
 
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