三级医院中皮肤撕裂伤预防现况的多中心研究  

Multi-center study on prevention condition of skin tears in level-III hospitals

作　　者：蒋琪霞[1] 郭艳侠[1] 江智霞[2] 郑关春 吴越香[4] 唐永利[5] 付红英[6] 陈丽娟[7] 李玉红[8] 封海霞[9] 陈玉盘[10] 沈定玉[11] 潘迎春[12] 贾静[13] 朱亚君 

机构地区：[1]南京军区南京总医院门诊伤口护理中心,210002 [2]遵义医学院附属医院护理部,563003 [3]中山大学附属肿瘤医院护理部,广州510060 [4]宁夏医科大学总医院伤口门诊,银川750004 [5]重庆医科大学附属第一院骨科,630014 [6]贵州省人民医院外科,贵阳550002 [7]厦门大学附属中山医院外科,厦门361004 [8]河北省唐山工人医院肿瘤科,063000 [9]东南大学附属中大医院内科,南京210000 [10]湖南省肿瘤医院外科,长沙410000 [11]江苏省苏州市立医院护理部,215001 [12]安徽省安庆市第一人民医院护理部,246004 [13]江苏省镇江市第一人民医院护理部,212002 [14]江苏省泰州市靖江市第一人民医院护理部,214500

出　　处：《中华现代护理杂志》2016年第24期3410-3414,共5页Chinese Journal of Modern Nursing

基　　金：南京军区创新课题（MS117）

摘　　要：目的：分析三级医院住院患者皮肤撕裂伤的预防现况，为制定预防策略提供依据。方法入选14所三级医院参与横断面调研，964名培训合格的护士采用便利抽样，在统一时间内使用一致的调研工具、方法和流程对住院≥24 h、年龄≥18岁并签署知情同意的患者实施从头到脚检查，并调查预防措施的落实情况。结果共获得有效资料18806例，发现皮肤撕裂伤199例238处，医院内发生率1.06％。风险评估和补充营养与水分落实率分别为3.92％和10.35％，预防跌倒和坠床落实率分别为51.58％和47.20％，使用辅助工具和润肤剂分别占28.23％和2.69％。采取适当移动技巧和穿长袖长裤或长袜分别占8.07％和6.95％。教学医院、综合医院和专科医院之间的皮肤撕裂伤发生率、风险评估及预防措施落实率差异有统计学意义（ P均〈0.05）。结论14所三级医院皮肤撕裂伤风险评估和预防现况均不理想，不同类型医院的预防措施不一致。今后需培训护士强化风险评估和预防意识，提高预防措施的执行率和一致性。Objective To analyze the prevention condition of skin tears of inpatients in level-III hospitals, so as to provide basis for making prevention strategies.Methods 14 level-III hospitals were involved＆amp;nbsp;in the cross-section survey. Within the same time period, using the same research tools, methods and procedure, 964 trained nurses inspected patients from head to toes, who were selected by convenience sampling, with hospital stay ≥24 h, with age≥18 years old, and with signature on the informed consent documents, and also investigated implementation of prevention measures. Results A total of 18 806 effective cases were obtained, with 238 locations of skin tears in 199 patients found. Incidence of hospital-acquired skin tears was 1. 06%. Implementation rate of risk assessment and nutrients and water supplement was 3. 92% and 10. 35%. Implementation rate of prevention of falling and falling down from bed was 51. 58% and 47. 20%. Usage of assistant tools and emollients accounted for 28. 23% and 2. 69%. Adopting suitable moving techniques and wearing long sleeves, trousers or long stockings accounted for 8.07% and 6.95%. Differences of incidence rate, risk assessment and implementation of prevention measures of skin tears among teaching hospitals, comprehensive hospitals and specialty hospitals were statistically meaningful （ P 〈 0. 05 for all ） . Conclusions Risk assessment and prevention of skin tears in these 14 level-III hospitals were not satisfactory. Prevention measures vary from different types of the hospitals. In future, nurses should be trained to strengthen awareness of risk assessment and prevention, and implementation rate and consistency of preventive measures should be improved.

关 键 词：皮肤撕裂伤 预防 横断面研究 

分 类 号：R473.6[医药卫生—护理学]