住院患者压疮现患率的多中心研究  

The point prevalence of pressure ulcers of inpatients: A multicenter studies

作　　者：蒋琪霞[1] 刘云[2] 管晓萍[3] 苏纯音 郭秀君[5] 陈月娟 朱亚君[7] 贾静 柏素萍[9] 张瑞 刘莉[11] 徐玲[12] 吴乐燕[13] 

机构地区：[1]南京军区南京总医院门诊部,南京护理学硕士210002 [2]南京军区南京总医院护理部,南京210002 [3]北京武警部队总医院护理部,北京100039 [4]无锡第二人民医院护理部,无锡214000 [5]南京市中医院护理部,南京210001 [6]常熟第二人民医院护理部,常熟215500 [7]靖江市人民医院护理部,靖江214504 [8]镇江第一人民医院护理部,镇江212002 [9]江苏大学附属医院烧伤科,镇江212000 [10]广州武警总队医院护理部,广州510507 [11]江苏省中医院肛肠外科,南京210029 [12]宿迁市中医院换药室,宿迁223800 [13]南京军区福州总医院烧伤科,福州354200

出　　处：《医学研究生学报》2013年第12期1298-1303,共6页Journal of Medical Postgraduates

基　　金：南京军区南京总医院科研基金(2010M012)

摘　　要：目的 国外将压疮（pressure ulcer,PU）现患率和发生率作为衡量医护质量指标之一,国内亦缺少多中心住院患者PU现患率和发生率的数据报道.研究旨在通过多中心横断面研究的方法学并分析所获结果的有效性和可靠性,为动态监测和采取预防措施提供基线依据.方法 根据欧洲PU专家组制定的微型数据集（minimum data set,MDS）,经过内部一致性信度检验后确定为有效的调研工具.讨论设计调研前准备流程和现场调研流程与方法,经过预实验证实可行.培训和考核12所医院457名护士熟练掌握多中心横断面研究设计,于同一时间采用同一研究方案和相同方法与工具实施横断面调查研究,并对数据进行统计学分析.结果 12所医院457名护士能够在规定时间内完成资料收集,获得有效资料39952例,有效率98.85%（39952/40415）.发现631例计1024处PU,其中HAPU 251例计323处.12所医院住院患者PU现患率为1.58%（0.94% ～2.97%）,HAPU现患率0.63%（0.20% ～1.20%）.PU现患率男性高于女性（2.04% vs 0.94%,P=0.000）,HAPU现患率男女差异无统计学意义（0.80% vs 0.40%,P=0.394）.PU高发年龄依次为〉89岁、80 ～89岁和70 ～79岁.PU好发部位为骶尾部、足跟和髂嵴.最多见的PU分期为Ⅱ期和Ⅰ期.PU高发的科室为ICU、老年科和神经内科.Braden量表用于不同年龄组的克隆巴赫系数为0.899 ～0.935,用于不同科系的克隆巴赫系数0.874～0.945.除产科和皮肤科等克隆巴赫系数0.684,有待完善.筛查出有PU危险患者共4710例,其中61.81%使用了减压床垫,74.01%每2h翻身1次;但仍有38.19%的PU危险者未使用减压装置,24.84%翻身无计划或无规律.结论 Ⅰ至Ⅱ期PU需要作为临床重点防控目标;骶尾部、足跟和髂棘需要加强检查;PU预防措施落实不良,需要加强.Objective Pressure ulcer is a worldwide health problem which can increase the duration stayed in hospitals, costs and morbidity. The prevalence and incidence of pressure ulcers is known as one of indicators for medical and nursing quality. However, there is no results of prevalence and incidence of pressure ulcers of inpatieuts from a multicenter studies in China so far. The aim of this study is to explore the methodology of muhicenter across-sectional investigation and analyze the effectiveness and reliability of results in order to provide the basis for predicting and preventing pressure ulcers. Methods Minimum Data Set （MDS） developed and tested by European Pressure Ulcer Advisory Panel was adopted as an across-sectional survey data collecting instrument after mutual- ly translation and inter-rater reliability teste. The preparation flows pre-survey and procedure flows on survey were discussed and de- signed, which were verified to be effective and reliable by pretest. Four hundred and fifty seven nurses from 12 hospitals were trained and checked. A point prevalence study was conducted in the same time using the same research program and the same method, and the data were analyzed. Results The effective data from 39 952 cases were obtained, and the effective rate was 98.85 % （39 952/40 415）. Six hundred and fifty-one patients with 1024 locations had pressure ulcers and 251 patients with 323 locations had hospital-ac- quired pressure ulcers. The prevalence of pressure ulcers and hospital-acquired pressure ulcers in inpatients are 1.58 % （from 0.94% -2.97% ） and 0.63 % （ from 0.20% - 1.20% ） , respectively. The prevalence of pressure ulcers in male was higher than that in female （2.04 vs 0. 94% , P =0. 000）. The prevalence of hospital-acquired pressure ulcers in male and female had no signifi- cant difference （0.80% vs 0. 40% , P = 0. 394）. The ages with high incidence of pressure ulcers are 〉 89 years, 80 -89 years, and 70 - 79 years in order. The common locations of pressure ulcers de

关 键 词：压疮 医院获得性压疮 现患率 横截面研究 

分 类 号：R472[医药卫生—护理学]