题名

運用皮膚照護群組降低重症病人壓力性損傷發生率

并列篇名

Skin Care Bundle Reduces the Incidence of Pressure Injury in Critically Ill Patients

DOI

10.6142/VGHN.201812_35(4).0004

作者

劉佳雯(Chia-Wen Liu);連如玉(Ru-Yu Lien);周欣宜(Hsin-Yi Chou);尚婉明(Wan-Ming Shang);盧淑芬(Shu-Fen Lu)

关键词

皮膚照護群組 ; 加護病房 ; 壓損 ; 發生率 ; skin care bundle ; intensive care unit ; pressure injury ; incidence rate

期刊名称

榮總護理

卷期/出版年月

35卷4期(2018 / 12 / 01)

页次

364 - 372

内容语文

繁體中文

中文摘要

壓力性損傷(Pressure injury)簡稱壓損,其發生率是醫護品質重要指標,重症病人因疾病嚴重度高、血循不穩及營養狀況不佳等因素是壓損高危險群。強化護理人員的知能,運用皮膚照護群組能有效預防壓損發生。本加護病房於2015年下半年壓損發生率1.37%,遠高於部訂閾值,經現況分析發現護理人員對壓損預防認知不足、壓損預防照護行為不正確及缺乏適當翻身輔具,故成立專案小組以加強在職教育、製作常見壓損部位圖示、修訂翻身時間暨禁忌表、製作壓損及高危險群警示貼紙並修訂預防壓損查核表及照護標準等皮膚照護群組進行降低壓損發生率改善方案,實施期間為2016年3-12月,於2016年6月至2017年1-3月發生率皆<0.39%,期此方案能提供全院重症單位參考,提昇重症病人臨床照護品質。

英文摘要

Pressure injury is a key index of quality of clinical care. In intensive care units (ICUs), patients who have a high severity of illness and unstable blood circulation and malnutrition status are at high risk of pressure injury. To strengthen the knowledge of nursing staff, a skin care bundle was used to effectively prevent pressure sores. Analysis revealed that from June to December 2015, pressure injury incidence was 1.37%. The contributing factors were the nursing staff's lack of knowledge of pressure injury, insufficient practice of the standard techniques of body turning and positioning, and lack of appropriate turning aids. Through group discussion, we determined that pressure injury incidence could be lowered by improving in-service education. Develop pressure injury easily recognize the site and table of high risk groups. A schedule was established for the repositioning of patients' bodies, with alternating, and a check form and standard procedures for the prevention of pressure injury were implemented. The implementation period was March to December 2016. After these measures were implemented, the incidence rate for pressure injury decreased to <0.39%. We document this experience to improve the quality of ICU care.

主题分类 醫藥衛生 > 預防保健與衛生學
醫藥衛生 > 社會醫學
参考文献
  1. 張素惠、張彩秀、陳妮婉(2013)。護理人員壓損預防行為之探討。弘光學報,69,136-153。
    連結:
  2. Anderson, M.,Finch Guthrie, P.,Kraft, W.,Reicks, P.,Skay, C.,Beal, A. L.(2015).Universal Pressure Ulcer Prevention Bundle With WOC Nurse Support.Journal of Wound Ostomy & Continence Nursing,42(3),217-225.
  3. Beeckman, D.,Van Lancker, A.,Van Hecke, A.,Verhaeghe, S.(2014).A systematic review and meta-analysis of incontinenceassociated dermatitis, incontinence, and moisture as risk factors for pressure ulcer development.Research in Nursing & Health,37(3),204-218.
  4. Black, J.,Clark, M.,Dealey, C.,Brindle, C. T.,Alves, P.,Santamaria, N.,Call, E.(2015).Dressings as an adjunct to pressure ulcer prevention: Consensus panel recommendations.International Wound Journal,12(4),484-488.
  5. Coyer, F.,Gardner, A.,Doubrovsky, A.,Cole, R.,Ryan, F. M.,Allen, C.,McNamara, G.(2015).Reducing pressure injuries in critically ill patients by using a patient skin integrity care bundle (InSPiRE).American Journal of Critical Care,24(3),199-209.
  6. McInnes, E.,Jammali-Blasi, A.,Bell-Syer, S.,Dumville, J.,Cullum, N.(2012).Preventing pressure ulcers--Are pressureredistributing support surfaces effective? A Cochrane systematic review and metaanalysis.International Journal of Nursing Studies,49(3),345-359.
  7. National Pressure Ulcer Advisory Panel,European Pressure Ulcer Advisory Panel,Pan Pacific Pressure Injury Alliance(2014).Prevention and treatment of pressure ulcers: Quick reference guide.
  8. Tayyib, N.,Coyer, F.(2016).Effectiveness of Pressure Ulcer Prevention Strategies for Adult Patients in Intensive Care Units: A Systematic Review.Worldviews on Evidence-Based Nursing,13(6),432-444.
  9. UlkerEfteli, E.,YapucuGunes, U.(2013).A prospective, descriptive study of risk factors related to pressure ulcer development among patients in intensive care units.Ostomy Wound Management,59(7),22-27.
  10. 陳妮婉、張彩秀、張素惠(2013)。護理人員壓損預防行為之系統性文獻查證。澄清醫護管理雜誌,9(2),40-47。
  11. 溫宛虹、武香君(2014)。降低某醫學中心感染科病房壓損發生率。安泰醫護雜誌,20(2),25-29。
  12. 趙慧玲、黃薇瑄、李怡旻、徐千淯、劉錦蓉、簡宛晴、連恒煇(2016)。運用系統教學設計模式建構壓損照護實作教學課程。台灣擬真醫學教育期刊,3(1),11-22。
  13. 醫院評鑑暨醫療品質策進會(2013).台灣臨床成效指標系統.取自http://www.tjcha.org.tw/FrontStage/page.aspx?ID=D8ADC4BA-00B0-45AD-8B37-29519C30B821
  14. 羅淑芬、張麗蓉、曹文昱(2012)。重症病人壓損問題的預防與照護。護理雜誌,59(4),24-29。
被引用次数
  1. 戴千淑,林少瑜,李佩玲(2021)。降低神經內科病房病人壓力性損傷發生率。榮總護理,38(4),413-421。