基于标准化方案的急诊压力性损伤预防实践现状及护理工作内容的田野研究  

Current status and nursing practice of pressure injury prevention in Emergency Department based on standardized protocol:a field study

作　　者：唐安林 吕坛 王静 朱雪元 黄频颖 杨亚平 TANG Anlin;LV Tan;WANG Jing;ZHU Xueyuan;HUANG Pinying;YANG Yaping(School of Medicine,Tongji University,Shanghai 200092,China;Dept.of Nursing Administration,Affiliated Yangpu Hospital,Tongji University,Shanghai 200090,China;Wound and Stoma Nursing Clinic,Affiliated Yangpu Hospital,Tongji University,Shanghai 200090,China;Dept.of Emergency,Affiliated Yangpu Hospital,Tongji University,Shanghai 200090,China)

机构地区：[1]同济大学医学院,上海200092 [2]同济大学附属杨浦医院护理部,上海200090 [3]同济大学附属杨浦医院伤口造口护理门诊,上海200090 [4]同济大学附属杨浦医院急诊科,上海200090

出　　处：《护理学报》2025年第5期13-18,共6页Journal of Nursing(China)

基　　金：上海市同济大学护理学院(筹)学科建设三年行动计划(2022-2025)领军人才项目(JS2210205)。

摘　　要：目的了解急诊压力性损伤预防实践现状及护理工作内容,明确当前护理实践现况与压力性损伤预防标准化方案之间的差距,并提出未来的研究方向。方法便利选取上海市某三级乙等医院急诊科的114例急诊患者,19名护士作为研究对象,急诊科作为田野地,采用非参与式观察结合非正式访谈的方式收集资料,并通过录音、拍摄照片的方式完善资料。结果急诊压力性损伤预防实践现状及护理工作内容包括皮肤状况检查与评估、压力性损伤风险因素评估、压力性损伤预防措施、家属态度与健康宣教4类主题,存在皮肤状况检查与风险评估待改进、压力再分配措施落实不足、营养评估及支持措施欠缺、健康教育效果不佳的问题。结论急诊压力性损伤预防实践与压力性损伤预防标准化方案存在差距,应深入分析压力性损伤预防标准化方案在急诊科应用的障碍因素,制定有效落实急诊压力性损伤预防措施的策略及流程。s:Objective To understand the current status of pressure injury prevention and nursing practice in emergency department,clarify the gap between the current nursing practice and the standardized protocol for pressure injury prevention,and propose future research directions.Methods Purposive sampling was used to select 114 patients and 19 nurses in emergency department of a tertiary grade-B hospital in Shanghai.We chose the emergency department as the field site and collected data through non participatory observation combined with informal interviews.The data were improved through recordings and photographs.Results Nursing practice for pressure injury prevention included four themes:skin condition examination and evaluation,pressure injury risk factor assessment,pressure injury prevention measures,family members’attitude and health education.Problems existing included the need for improvement in skin condition examination and risk assessment,inadequate implementation of pressure redistribution measures,lack of nutritional assessment and support measures,and ineffective health education.Conclusion There is a gap between pressure injury prevention and its standardized protocol in emergency department.It is necessary to conduct in-depth analysis of the barriers to implementing standardized protocols and develop effective strategies and processes for implementing pressure injury prevention measures in emergency department.

关 键 词：急诊 压力性损伤 田野研究 实施科学 预防 

分 类 号：R472[医药卫生—护理学]