强化患者绩效与安全的策略与工具在血液透析患者高磷血症饮食管理中的应用  

Application of Team Strategies ＆ Tools to Enhance Performance and Patient Safety for hyperphosphatemic dietary management in outpatients on maintenance hemodialysis

作　　者：徐少波[1] 施剑斌[1] 吴春燕[1] Xu Shaobo;Shi Jianbin;Wu Chunyan(Hemodialysis Center,Sir Run Run Shaw Hospital Affiliated to Zhejiang University Medical School,Hangzhou 310016,China)

机构地区：[1]浙江大学医学院附属邵逸夫医院下沙院区血透室,杭州310016

出　　处：《中国实用护理杂志》2018年第30期2331-2334,共4页Chinese Journal of Practical Nursing

基　　金：浙江省教育厅一般科研项目（Y201533926）

摘　　要：目的探讨强化患者绩效与安全的策略与工具（TeamSTEPPS）在维持性血液透析门诊患者高磷血症管理中的应用效果。方法将2016年4—6月行血液透析治疗的56例门诊患者设为对照组，将2016年10—12月行血液透析治疗的60例门诊患者设为观察组；对照组采用常规饮食管理模式，观察组运用TeamSTEPPS制订血液透析患者高磷血症的饮食管理模式，比较2组患者高磷血症及低蛋白血症发生率、医护人员及患者高磷血症饮食管理知识考核成绩。结果高磷血症发生率对照组为60．7％（34／56），观察组为41．7％（25／60），2组比较差异有统计学意义（X^2=4．20，P=0．036）。低蛋白血症发生率对照组为39．3％（22／56），观察组为25．0％（15／60），2组比较差异无统计学意义（X^2=2．72，P=0．102）。医护人员和患者的高磷血症饮食管理知识考核成绩分别为对照组（75．1±5．1）分和（69．7±6．4）分，观察组为（88．4±2．6）分和（80．1±6．5）分，2组比较差异有统计学意义（t=15．82、-8．84，P=0．oo）。结论TeamSTEPPS在维持性血液透析门诊患者高磷血症的饮食管理中发挥了积极作用，在不影响患者营养状况的情况下，降低了高磷血症的发生率。Objective To explore the effectiveness of Team Strategies ＆ Tools to Enhance Performance and Patient Safety （TeamSTEPPS） in reducing hyperphosphatemia of outpatients on maintenance hemodialysis. Methods A total of 56 outpatients on hemodialysis received traditional dietary management from April to June,2016 were as control group, and 60 patients from October to December,2016 with TeamSTEPPS implemented in hyperphosphatemic dietary management were as observation group. The difference of the incidence rate of hyperphosphatemia and hypoproteinemia, grasp of knowledge of hyperphosphatemic dietary management were compared between two groups and medical staffs. Results The incidence rate of hyperphosphatemia were dropped from 60.7% （34/56） in control group to 41.7%（25/60） in observation group, difference between two groups had statistical significance（X^2= 4.20, P=0.036）. The hypoproteinemia had no statistical difference between two group（X^2=2.72, P=0.102）, but still dropped from 39.3% （22/56） in control group to 25.0% （15/60） in observation group. Grasp of knowledge of hyperphosphatemic dietary management were rised from （75.1±5.1） points and （69.7±6.4） points in control group and medical staffs to （88.4±2.6） points and （80.1±6.5） points in observation group and medical staffs respectively, and there were significant differences（t=15.82-8.84, P=0.00）. Conclusions The application of TeamSTEPPS for hyperphosphatemic dietary management in outpatients on maintenance hemodialysis can effectively decrease the incidence of the hyperphosphatemia.

关 键 词：维持性血液透析 高磷血症 饮食管理 TeamSTEPPS 

分 类 号：R473.5[医药卫生—护理学]