降低內科加護病房新增壓瘡發生密度之專案

A Project to Reduce Patient Pressure Sore Incidence Density in the Medical Intensive Care Unit

吳貞蓉(Chen-Jung Wu)；侯怡吟(Yi-Yin Hou)；黃楨婷(Jhen-Ting Huang)

壓瘡 ； 加護病房 ； pressure sore ； intensive care unit

嘉基護理

15卷1期（2015 / 06 / 01）

6 - 18

繁體中文

壓瘡在加護病房是常見的問題，更是重要的臨床品質指標，一旦病患出現壓瘡，不但延長住院天數、增加醫療成本。本單位2012年新增壓瘡發生密度為0.32%，超過護理部閾值0.04%，故專案目的為降低內科加護病房新增壓瘡密度發生，經分析問題有病人特性複雜度高、護理人員對於預防壓瘡認知不足、護理人員翻身擺位技術未落實且未有稽核制度、輔具不良。因此專案擬定相關措施，藉由舉辦在職教育、培育臨床教師種子稽核翻身技術、製作警示牌及床頭30度角度卡、改良現有輔具及團隊交班平台的運用，可有立即時效性的回饋，也使得交班及翻身的完整率提升，專案執行後壓瘡發生密度為0%。本專案結果未來可在各加護病房推廣，提升護理照護品質。

Pressure sore is not just a common problem in the intensive care unit, but also a vital quality indicator. It could increase the length of stay and the medical cost. The pressure-sore incidence density in our unit was 0.32%. It exceeded the threshold of nursing department in our hospital for 0.04%. The purpose of the project was to reduce the patient pressure sore incidence density in our unit. Through the situation analysis, the problems were as follows: the complexity of patient characteristic, the insufficient knowledge of pressure ulcer prevention of nurses, a lack of practice of position changing, no auditing system and poor quality of pressure-reducing surface. Several strategies were adopted, including arranging in-service education, training seed teachers for auditing the skill of position changing, creating warning signs and protractor, improving the existing tools and using the collaborative platform for effective feedback. The completeness rate of handover and position changing were elevated, while the patient pressure sore incidence density was reduced to 0%. The result of the project could serve as a reference for promoting quality in nursing care of intensive care units.

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