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提升末期腎病病人預先建立透析動靜脈瘻管完成率
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Journal Article
提升末期腎病病人預先建立透析動靜脈瘻管完成率
2025
Overview
背景：末期腎病病人於透析前若沒有預先建立透析動靜脈瘻管，則需使用短期通路透析，因而影響病人生活品質及存活率，本單位統計2021年6月至2022年5月末期腎病病人預先建立透析動靜脈瘻管完成率僅20.4%。分析原因為：（一）病人或家屬認知正確率僅49.3%；（二）個管師衛教方式不一致；（三）執行醫病共享決策（shared decision making）後沒有後續追蹤病人的抉擇；（四）病人告知透析模式意願後，缺乏溝通平台，導致預先建立透析通路的告知時機不一致。目的：末期腎病病人預先建立透析動靜脈瘻管完成率提升至40.1%。解決方案：（一）增加輔助教學工具、（二）優化衛教工具及流程、（三）強化醫病共享決策追蹤機制。結果：末期腎病病人預先建立透析動靜脈瘻管完成率由20.4%提升至41.2%。結論：除了達到本專案之目的外，其附加效益為降低病人住院天數、減少醫療耗材成本支出。
