基于循证及SSKINS临床管理模式构建骨科患者器械相关压力性损伤预防方案  

Construction of device-related pressure injury prevention program in orthopedics patients based on evidence-based and SSKINS clinical management model

作　　者：何子涵 王慧文 晏蓉 李素云 刘云访 万雅莉 皮蓉 刘方[6] 汪艳[7] He Zihan;Wang Huiwen;Yan Rong;Li Suyun;Liu Yunfang;Wan Yali;Pi Rong;Liu Fang;Wang Yan(Department of Nursing,Union Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China;School of Nursing,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China;Department of Orthopedics,Union Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China;Department of Thoracic Surgery,Union Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China;Department of Neurosurgery,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China;Department of Infectious Diseases,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China;Department of Nursing,Union Jingshan Hospital,Huazhong University of Science and Technology,Jingshan 431899,China)

机构地区：[1]华中科技大学同济医学院附属协和医院护理部,武汉430030 [2]华中科技大学同济医学院护理学院,武汉430030 [3]华中科技大学同济医学院附属协和医院骨科,武汉430030 [4]华中科技大学同济医学院附属协和医院胸外科,武汉430030 [5]华中科技大学同济医学院附属协和医院神经外科,武汉430030 [6]华中科技大学同济医学院附属协和医院感染科,武汉430030 [7]华中科技大学协和京山医院护理部,京山431899

出　　处：《中国实用护理杂志》2025年第8期593-600,共8页Chinese Journal of Practical Nursing

基　　金：协和京山医院科研项目(2023-XHJS-005)。

摘　　要：目的基于循证及SSKINS(S:皮肤,S:支撑面,K:活动,I:失禁/潮湿,N:营养,S:自我护理)临床管理模式构建骨科患者器械相关压力性损伤预防方案,为临床护理实践提供借鉴。方法2023年6月成立研究小组,检索骨科患者器械相关压力性损伤相关文献,参考SSKINS临床管理模式,进行证据提取和筛选,并结合临床实际拟定方案初稿。2023年10-12月通过2轮专家函询确定最终方案。结果2轮专家函询回复率均100%(20/20),专家权威系数分别为0.897和0.907。2轮函询总体Kendall协调系数分别为0.116和0.136,各级条目Kendall协调系数为0.104~0.213(均P<0.001)。最终方案包含6个一级条目(评估与检查、器械的使用与调整、预防性敷料、皮肤保护、营养支持、健康教育)和31个二级条目。结论构建的骨科器械相关压力性损伤预防方案具有科学性和实用性,可为临床医护人员预防管理提供参考。Objective To construct a device-related pressure injury prevention program for orthopedic patients based on evidence-based and SSKINS(S:skin,S:surface,K:keep moving,I:incontinence,N:nutrition,S:self-care)clinical management model,and to provide reference for clinical nursing practice.Methods In June 2023,a research team was set up to retrieve the literature related to device-related pressure injury in orthopedic patients,and the evidence was extracted and screened with reference to the SSKINS clinical management model,and the first draft of the protocol was formulated based on clinical practice.The final plan was determined through two rounds of expert consultations from October to December 2023.Results The response rate of the two rounds of expert correspondence was 100%(20/20).The expert authority coefficients were 0.897 and 0.907,the overall Kendall coordination coefficients of the two rounds were 0.116 and 0.136 respectively,and the Kendall coordination coefficients of all levels were 0.104-0.213(all P<0.001).The final protocol contains 6 first-level items(assessment and examination,the use and adjustment of device,prophylactic dressings,skin protection,nutritional support,health education)and 31 second-level items.Conclusions TThe proposed orthopedic devicerelated pressure injury prevention program is scientific and practical,and can provide a reference for the prevention and management of clinical medical staff.

关 键 词：骨科 器器械相关压力性损伤 预防 行循证 方案构建 

分 类 号：R47[医药卫生—护理学]