综合医院压疮预防现状多中心调查  

Investigation of prediction and prevention status for pressure ulcers in comprehensive hospitals

作　　者：蒋琪霞[1] 刘亚红[2] 郭秀君[3] 陈月娟[4] 刘海英 管晓萍[6] 朱亚君[7] 贾静[8] 柏素萍[9] 张瑞[10] 刘莉[11] 徐玲[12] 吴乐燕[13] 刘云 

机构地区：[1]南京军区南京总医院门诊部伤口护理中心,210002 [2]南京军区南京总医院神经内科,210002 [3]南京市中医院护理部,210001 [4]江苏省常熟市第二人民医院护理部,215500 [5]江苏省无锡第二人民医院护理部,214002 [6]北京武警部队总医院护理部,100039 [7]江苏省靖江市人民医院护理部,214500 [8]江苏省镇江市第一人民医院护理部,212002 [9]江苏大学附属医院烧伤整形科,212001 [10]武警广东总队医院护理部,广州510507 [11]江苏省中医院肛肠外科,210006 [12]江苏省宿迁市中医院护理部,223800 [13]南京军区福州总医院烧伤整形科,315000 [14]不详

出　　处：《中华现代护理杂志》2012年第36期4359-4362,共4页Chinese Journal of Modern Nursing

基　　金：南京军区南京总医院面上课题（2010M12）

摘　　要：目的分析12所综合医院中住院患者压疮预防现况，并提出对策。方法采用欧洲和美国的调研工具，设定统一的调研时间、方法和流程及其一致性判断标准，组织统一培训合格的护士457名，对12所综合医院≥18岁的住院患者实施横断面调研，从压疮危险预测评分、减压床垫和翻身计划等方面分析压疮预防现况，采用SPSS16．0统计软件进行描述性统计分析。结果有效资料39952例，压疮现患率1．579％（651／39952），医院获得性压疮发生率0．628％（251／39952）。Braden计分≤16分4710例，压疮危险初评落实率50．235％，复评落实率56．645％。其中380例院外压疮带入者Braden计分初评落实率87．38％，复评落实率90．842％。医院内获得性压疮251例每日1次复评落实率95．219％，1094例危重患者Braden计分初评落实率94％，每日1次复评率69．104％。4710例压疮发生危险者床上减压装置落实率61．805％，椅上减压装置落实率3．652％；床上体位变换落实率75．138％，椅上体位变换落实率7．834％。临床护士的评分结果为（14．01±3．54）分，与骨干护士复评结果（13．29±3．54）分比较差异有统计学意义（t=3．221，P〈0．01）；压疮发生危险患者使用减压垫状况及定时变换体位情况比较差异均有统计学意义（P〈0．01）。结论在综合性医院中压疮预测评分和预防措施均未达到指南要求，需要建立压疮预警管理组织架构和分层次培训压疮预防知识，强化临床护士压疮预防意识和定期督查指导。Objective To analyze the status of prediction and prevention for pressure ulcers in comprehensive hospitals in order to get suggestions for pressure ulcers. Methods Using consensus investigating times, tools, ways and procedure flows and judgment criteria, and organizing 457 nurses who trained and passed examination to do a cross-sectional investigation for condition of prediction and prevention for pressure ulcers in 12 comprehensive acute care hospitals. Data were calculated by SPSS 16.0 statistic software. Results Totals of 39 952 cases run into the database,the prevalence of pressure ulcers was 1. 579% and the incidence of hospital- acquired pressure ulcers was 0. 628 % （251/39 952）. Out of patients with Braden scale ~〈 16 points totally 4 710 cases,the first assessment rate was 50. 235% and reassessment rate was 56. 645%. The first assessment rate of 380 patients found out pressure ulcers on admission was 87.38% and reassessment rate was 90. 842%. The reassessment rate of 251 patients with hospital-acquired pressure ulcers was 95. 219%. The first assessment rate of 1 094 critical care patients on admission was 94% and reassessment rate was 69. 104%. The application rate of support surfaces or devices on beds and chairs for 4 710 patients with risk of pressure ulcers was 61. 805% and 3. 652%, respectively. The regular changing position rate on beds and chairs for 4 710 patients with riskof pressure ulcers was 75. 138% and 7. 834% respectively. The difference of Braden scores by clinical nurses and trained wound care team nurses was significant[ （ 14. 01 ＋3.54 ） vs （3.29 ± 3.54） ;t = 3. 221 ,P 〈 0. 01 ]. Pressure ulcer risk patients use decompression pad status and timing change positions comparative differences were statistically significant （ P 〈 0.01 ）. Conclusions The results of prediction and prevention for pressure ulcers in twelve comprehensive hospitals did not meet the guidelines＇ aim. It is important to set up the organized frame and train different professional nurses for

关 键 词：压力性溃疡 横断面研究 数据收集 预防 

分 类 号：R473.6[医药卫生—护理学]