住院患者压疮现患率调研及预防现状分析

摘要

目的 分析市级三级甲等综合医院住院患者压疮现患率及预防措施落实现况,并以此采取针对性护理对策.方法 通过对伤口造口学组成员培训,采用欧洲和美国的调研工具,分别于2015年12月、2016年6月对年龄≥18岁的住院患者实施现患率调查,统计压疮现患率及医院获得性压疮(HAPU)发生率,并从Braden评分、减压工具的使用及翻身计划分析压疮预防情况.结果压疮现患率、HAPU发生率分别为0.945％、0.293％;高危科室依次为重症监护室、内科、外科;高危部位主要为股骨大转子、骶尾部;高危患者及压疮患者减压工具使用率分别为59.32％、62.07％;翻身落实率分别为75.33％、86.21％;且临床护士和调研护士对患者的Braden评分存在差异.结论 股骨大转子、骶尾部是压疮重点防护部位;重症监护室是压疮防范重点科室.该院压疮风险评分及预防措施均未达指南要求,需要健全压疮督查指导制度、规范压疮预防标准化作业及强化压疮预防知识培训.%Objective To analyze the prevaleuce and prevention measures of pressure ulcer in inpatients of municipal 3A hospitals,and to take specific nursing strategies.Methods By training the wound ostomy nursing team members and using European and US research tools,we surveyed the prevalence of pressure ulcer among inpatients aged older than or equal to 18 years old in December 2015 and June 2016,respectively,in Anqing Municipal Hospital.Pressure ulcer prevalence and the hospital acquired pressure ulcer (HAPU) incidence were calculated,and analysis was made of pressure ulcer prevention situation from Braden scores,use of decompression tools and turnover plan.Results The prevalence of pressure ulcer and incidence of HAPU were 0.945％,and 0.293 ％,respectively.Highrisk sections were units of intensive care,internal medicine,and surgery in sequence.High-risk sites were greater trochanter of femur,and sacrococcygeal region.Decompression tool utilization rates of high-risk patients and pressure ulcer patients were 59.32％ and 62.07％,respectively.And their turnover rates were 75.33％ and 86.21％,respectively.There are differences in Brand scores between clinical nurses and research nurses on patients.Conclusions Greater trochanter of femur aud sacrococcygeal region were the critical sites for pressure ulcer prevention.ICU was the key department to prevent pressure ulcer.The risk score and preventive measures of pressure ulcer were not up to guidelines,therefore,it is necessary to improve the supervision and guidance system of pressure ulcer,standardize pressure ulcer prevention aud strength knowledge training of pressure ulcer prevention.