无创通气设备相关面部压力性损伤预防的证据总结  

Evidence summary of prevention of Noninvasive Ventilation related facial Pressure Injuries

作　　者：刘晓黎 王泠[2] 王志稳[4] 孙红[3] 袁军凤[3] LIU Xiaoli;WANG Ling;WANG Zhiwen;SUN Hong;YUAN Junfeng(Operating Room,Peking University People's Hospital,Beijing,100044,China)

机构地区：[1]北京大学人民医院手术室,100044 [2]北京大学人民医院护理部,100044 [3]北京大学人民医院急诊科,100044 [4]北京大学护理学院

出　　处：《中国护理管理》2019年第10期1532-1537,共6页Chinese Nursing Management

摘　　要：目的:评价并整合预防无创通气设备相关面部压力性损伤的证据。方法:检索加拿大安大略注册护士协会(RNAO)、英国国家卫生与临床优化研究所(NICE)、苏格兰学院间指南网(SIGN)、美国指南网(NGC)、国际指南网(GIN)、医脉通、BMJ 最佳临床实践(British Medical Journal Best Practice)、UpToDate、CochraneLibrary、Joanna Briggs Institute(JBI)Library、PubMed、荷兰医学文摘数据库(Embase)、中国知网(CNKI)、万方数据库(WanFang Data)、欧洲压疮咨询小组(EPUAP)官网、美国伤口造口失禁护理学会(WOCN)、欧洲呼吸学会(ERS)、明尼苏达医院协会的相关指南、系统评价和专家共识,采用澳大利亚JBI 循证卫生保健中心的文献评价标准和证据分级系统,对不同类型研究进行文献质量评价及证据级别评定。结果:共纳入6 篇文献,其中2 篇指南、1 篇证据总结、2 篇系统评价、1 篇专家共识。总结了23 条预防无创通气设备相关性面部压力性损伤的证据,包括风险因素和高危部位识别、连接界面的选择、皮肤评估、压力再分布、预防性使用敷料等。结论:医务人员应结合医院的具体情况按照相关级别的循证医学证据,规范无创通气设备的管理,保证患者安全,减少相关压力性损伤的发生。Objective: To select, assess and summarize the available evidences on prevention of Noninvasive Ventilation (NIV) related Pressure Injuries (PI). Methods: We searched the Registered Nurses' Association of Ontario (RNAO), National Institute for Health and Clinical Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN), National Guideline Clearinghouse (NGC), Guidelines International Network (GIN), Medlive.cn, British Medical Journal Best Practice (BMJ Best Practice), UpToDate, Cochrane Library, Joanna Briggs Institute Library, PubMed, Embase, CNKI, WanFang Data, European Pressure Ulcer Advisory Panel (EPUAP), Wound Ostomy and Continence Nurses Society (WOCN), European Respiratory Society (ERS), Minnesota Hospital Association to collect literatures including guidelines, systematic reviews and consensus. The JBI evidence appraisal and recommendation system was used to evaluate the quality of studies and the level of evidence. Results: 6 references were retrieved including 2 guidelines, 1 evidence summary, 2 systematic reviews and 1 consensus. A total of 23 items of evidences were summarized with regard to identifying risk factors and locations, choosing adequate interface, assessing skin regularly, pressure distribution, using prophylactic dressings, etc. Conclusion: Healthcare workers are supposed to normalize management over noninvasive ventilation equipments and avoid the occurence of pressure related injuries to ensure the safety of patients according to correspondent evidences summarized as well as taking the specific conditions of hospitals into consideration.

关 键 词：无创通气 预防 压力性损伤 证据总结 

分 类 号：R47[医药卫生—护理学]