降低某醫學中心感染科病房壓瘡發生率

Reducing the Incidence of Pressure Ulcers in the Infectious Ward of a Medical Center

溫宛虹(Wan-Hung Wen)；武香君(Hsiang-Chun Wu)

壓瘡 ； 壓瘡發生率 ； 預防壓瘡 ； pressure ulcers ； incidence of pressure ulcers ； pressure ulcer prevention

安泰醫護雜誌

20卷2期（2014 / 12 / 01）

25 - 39

繁體中文

壓瘡發生率是醫療照顧品質的重要指標。本單位自2009年壓瘡平均月發生率為0.98%，較2008年壓瘡平均月發生率0.41%，增加0.57%，且於2010年1月至6月攀升為1.09%，壓瘡發生率已成為單位需迫切改善之品管指標。專案小組成員分析導致高壓瘡發生率的原因包括：護理人員的壓瘡預防及翻身擺位認知不足、缺乏相關標準流程、衛教工具及翻身輔助工具不足等問題。有鑑於此，專案實施介入措施，包括：壓瘡在職教育宣導、提供適當的翻身工具、設計多元性的衛教工具，包括：衛教單張、海報與多媒體翻身示範影片，制定與宣導標準作業流程，藉此讓護理人員能了解預防壓瘡的工作流程與指引，提升護理人員照顧的正確性及落實度。經以上措施執行，單位壓瘡平均月發生率由1.09%下降為0.21%，顯示成效良好。期望藉此專案，進而提升護理照護品質。

The incidence of pressure ulcers is an important indicator of quality of medical care. The mean monthly incidence of pressure ulcers in the study unit in 2009 was reported as 0.98%, which was 0.57% higher than that reported in 2008 (0.41%) and rose up to 1.09% between January and June in 2010. The incidence of pressure ulcers has become the top priority quality indicator that requires urgent improvement. The causes of high incidence of pressure ulcers were analyzed by the project team and identified as follows: insufficient cognition of pressure ulcer prevention as well as turning and positioning, lack of standard operating procedures, and inadequate educational and auxiliary turning tools. The intervention strategies included (1) providing in-service education on pressure ulcer care, (2) providing adequate tools for patient turning, (3) designing multiple educational tools such as health education pamphlets and posters and multimedia/video demonstrations on turning, and (4) establishing and advocating standard operating procedures. These strategies intended to contribute to increased knowledge of nurses with regard to the work procedures and guidance of pressure ulcer prevention, thereby improving their correctness and implementation of care. The mean monthly incidence of pressure ulcers in the study unit decreased from 1.09% to 0.21%, indicating a significant improvement after the intervention. This project could serve as a reference for improving the quality of nursing care.

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