頁籤選單縮合
| 題 名 | 運用醫品圈降低血液透析患者動靜脈瘻管阻塞率之前瞻性研究=Use of Healthcare Quality Improvement Circle Intervention to Decrease the Arteriovenous Shunt Occlusion Rate in Hemodialysis Patients |
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| 作 者 | 丁郁芬; 連琇怡; 鄭晶丹; 廖上智; 謝春滿; | 書刊名 | 醫務管理期刊 |
| 卷 期 | 14:4 2013.12[民102.12] |
| 頁 次 | 頁338-355 |
| 分類號 | 419.73 |
| 關鍵詞 | 動靜脈瘻管; 血管通路; 血液透析; 醫品圈; Arteriovenous shunt; Blood access; Hemodialysis; Healthcare quality improvement circle; |
| 語 文 | 中文(Chinese) |
| 英文摘要 | Objective: This project aimed to evaluate the effects of the Healthcare Quality Improvement Circle Intervention (HQCI) on reducing the arteriovenous (A-V) shunt occlusion rate in hemodialysis patients through identification of problems, formulation of an intervention, and institution of the HQCI. The function of the A-Vshunt is highly associated with the health and safety of patients undergoing hemodialysis, and serves as a patient's vital lifeline.Methods: A quasi-experimental and single arm crossover design with two groups (pre- and post-test) was conducted. Through purposive sampling, subjects were recruited from a hemodialysis unit of a regional hospital in southern Taiwan. Eight hundred twenty-six subjects participated in the routine care group and 808 subjects participated in the HQIC group. The intervention period was 1 month. Based on the system map, factors contributing to the high occlusion rate were analyzed, and the PDCA circulation matrix was used to identify and solve problems. The intervention strategies included individualized A-V shunt care education, use of a scale cup for liquid intake, determining water consumption based on disease categories, use of a standardized procedure for net body-weight, development of a standardized procedure for abnormal events, and design of an individualized and accurate vascular map.Results: The average occlusion rate for the control group on pre- and post-test was 4.1±.9% and 4.6±1.6%, respectively. After the intervention, the occlusion rate decreased in the HQIC group (t=17.2, P<.001). The average occlusion rate for the HQIC group on pre- and post-test was 4.6±1.6% 1.6±.7%, respectively. The HQIC group had greater improvement than the control group (t=13.51, P<.001).Conclusion: The findings of this project demonstrated that the HQCI can reduce the A-V shunt occlusion rate for hemodialysis patients. This improvement can be attributed to the implementation of a standardized care procedure and providing critical individualized information. The results of the current study will facilitate A-V shunt care quality improvement in hemodialysis patients. It is hoped that mutual experience sharing will take place. |
本系統中英文摘要資訊取自各篇刊載內容。