臨牀透析 Vol.18 No.3(3)


特集名 透析看護における患者ケアを評価する
題名 血液透析看護度表の作成と活用
発刊年月 2002年 03月
著者 春木谷 マキ子 大阪府立病院・看護婦
【 要旨 】 重篤な合併症を有する患者,高齢者,糖尿病性腎症患者の透析導入の増加や長期維持透析患者が増加し,透析中の看護密度も高くなっているが,それらを客観的に測定する尺度はない.透析中のケアを,安全,安楽,確実に行う目的で,血液透析看護度表(看護度)を作成した.看護度は看護密度を数量化でき,患者の重症度ともよく一致し,看護ケア内容も明確となった.高齢透析導入患者28名の1年経過後の予後を調査したところ,看護度5点以下の14名は全員年齢相応の社会復帰を果たしていた.75歳以上の高齢者では看護度10点以上の5名は全員死亡していた.以上より,われわれの看護度から予後が予測できる可能性が示唆された.
Theme Evaluation of Caring in Dialysis Patients
Title Establishment and practical use of the degree table for hemodialysis nursing
Author Makiko Harukidani Department of Nursing, Osaka Prefectural General Hospital
[ Summary ] The quantity of nursing needed for dialysis patients is increasing, because of the increase in patient dialysis initiation. The number of older and diabetic patients who have severe complications, and the number of long-term maintenance dialysis patient is increasing. However, there is no objective measurment of these factors. We established the degree table for hemodialysis care for patients receiving dialysis nursing to increase safety and comfort for these patients. The nursing degree table has quantified nursing performance. Use of this table produces a higher degree of patient well being.
Moreover, by using the nursing degree table, factors concerning nursing care were clarified. The one year prognosis for twenty eight elderly patients, for whom dialysis was initiated was investigated. All fourteen patients receiving level five or lower degrees of nursing were able to receive social-rehabilitation. Of those patients seventy five years old or older, five who were receiving level ten or above nursing care expired. These findings suggest that a prognosis could be predicted on the degree of nursing quality.
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