基于最佳证据的住院患者压力性损伤预防及护理流程图的制作  

Development of a Flowchart for the Prevention and Management of Pressure Injuries in Inpatients Based on Best Evidence

作　　者：王雪儿 丁娟[1] WANG Xue-er(Jingzhou Hospital affiliated to Yangtze University Jingzhou 434020,Hubei,China)

机构地区：[1]长江大学附属荆州医院,湖北荆州434023 [2]长江大学医学部,湖北荆州434023

出　　处：《牡丹江医科大学学报》2025年第2期89-95,共7页Journal of Mudanjiang Medical University

基　　金：湖北省科技创新专项立项项目(2021CFB601)。

摘　　要：目的评价并总结住院患者压力性损伤预防及护理相关证据,根据最佳证据制作住院患者压力性损伤预防及护理流程图,为临床护士提供实践依据。方法计算机检索BMJ、Up To Date、英国国家卫生与临床优化研究所、苏格兰院际指南网、美国指南网、澳大利亚JBI循证卫生保健数据库、加拿大安大略省注册护士协会网站、Embase、PubMed、Web of Science、Cochrane Library、中国生物医学文献数据库、医脉通、万方数据关于住院患者压力性损伤预防及护理的相关文献。检索时间为建库至2024年6月1日。对文献质量进行评价,提取整合、评审证据;根据最佳证据制作压力性损伤护理流程图。结果最终纳入12篇文献,5篇指南,6篇系统评价及Meta分析,1篇专家共识。总结包括皮肤评估、风险评估、评估工具、体位变换、营养、疼痛评估、清洗与清创、伤口敷料8个方面的内容,29条最佳证据,并制作了压力性损伤预防及护理的流程图。结论该研究总结了住院患者压力性损伤预防及护理的最佳证据,并根据最佳证据制作压力性损伤预防及护理流程图,可为临床医护人员预防及护理压力性损伤提供参考。Objective To evaluate and summarize the evidence on the prevention and management of pressure injuries in hospitalized patients.Based on the best available evidence,a flowchart for the prevention and management of pressure injuries in inpatients was developed to provide a framework for clinical nursing practice.Methods A comprehensive computer-based search was conducted in databases including BMJ,UpToDate,National Institute for Health and Care Excellence,Scottish Intercollegiate Guideline Network,National Guideline Clearinghouse,JBI,Registered Nurses'Association of Ontario,Embase,PubMed,Web of Science,Cochrane,Chinese Biomedical Literature Database,YiMai Tong,and Wanfang Data,focusing on the prevention and management of pressure injuries in inpatients.The search covered literature from database inception until January 1,2024.The quality of the included studies was evaluated,and relevant evidence was extracted,integrated,and reviewed.Based on the best available evidence,a flowchart for pressure injury management was developed to guide clinical practice.Results A total of twelve articles,five guidelines,six systematic reviews and meta-analyses,and one expert consensus were included in the analysis.The summary encompasses eight key aspects:comprehensive skin assessment,pressure injury(PI)risk assessment,assessment tools,body position transformation,nutrition,pain assessment,cleaning and debridement,and wound dressing.Based on these findings,a flowchart for the prevention and care of pressure injuries was developed.Conclusion This study summarizes the best evidence for the prevention and care of pressure injuries in hospitalized patients and develops a flowchart based on this evidence.This flowchart can serve as a reference for clinical healthcare professionals in preventing and managing pressure injuries.

关 键 词：压力性损伤 住院患者 护理 流程图 循证护理学 

分 类 号：R473.5[医药卫生—护理学]