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醫療器材相關壓力性損傷預防策略

Medical Device Related Pressure Injury Prevention Strategies

摘要


2016年美國國家壓瘡諮詢委員會之壓瘡名詞及分級全球專家共識會議,決議納入醫療器材相關壓力性損傷。可見此醫源性傷害逐漸受重視。相較於骨突處的壓力性損傷,可以運用翻身擺位緩解局部持續的壓力,醫療器材的安全固定與不可移除性,更增加臨床壓力性損傷預防與照護的困難度。再者,顏面皮膚與黏膜是最常見損傷發生部位,一旦發生,容易造成外貌毀損與功能喪失,甚而導致骨頭暴露引發感染,導致潛在醫療糾紛發生危機。因此近幾年來,國外開始針對此範疇進行探討與揭露,但國內目前對醫療器材相關壓力性損傷探討仍付之闕如,因此本文透過國內外文獻查證與結合臨床實證,針對醫療器材相關壓力性損傷的定義、危險因子、損傷分級、預防策略等進行全面闡述,以提供健康照護專業人員新知,期許能對臨床醫療器材相關壓力性損傷之預防與照護有所助益,以降低其發生率與傷害程度。

關鍵字

醫療器材 壓力性損傷 預防 策略

並列摘要


Medical Device Related Pressure Injury was incorporated into the redefinition of pressure injuries during the National Pressure Ulcer Advisory Panel 2016 Staging Consensus Conference. It is evident that this type of iatrogenic injury is gradually receiving more attention. Unlike pressure injuries over a bony prominence, which may be alleviated by repositioning different body parts, injuries that require non-retractable medical devices to be securely fastened to an injury site carry a higher risk of causing pressure injuries and of requiring subsequent care in a clinical setting. Furthermore, facial skin and mucosal membranes are the most common sites of Medical Device Related Pressure Injuries. Once these injuries occur, they easily result in damage to appearance, loss of function, and even bone exposure and infection, which may lead to medical disputes. Therefore, in recent years, research and exploration in this field has increased in many countries. However, discussions regarding Medical Device Related Pressure Injuries in Taiwan are still lacking. Thus, the aim of this article is to discuss the definition, risk factors, damage classification, and prevention strategies of Medical Device Related Pressure Injuries by combining domestic and international literature reviews and clinical verifications for the purpose of providing knowledge to medical staffs in hopes of reducing the incidence of Medical Device Related Pressure Injuries and degree of damage.

並列關鍵字

medical device pressure injury prevention strategy

參考文獻


王淑鈴、莊寶玉、舒婉娟(2018).運用組合式照護降低心臟加護病房醫療裝置相關壓傷發生密度.護理雜誌,65(3),80–87。[Wang, S. L., Chuang, P. Y., & Su, W. C. (2018). Application of care bundles to reduce medical-device-related pressure injury (MDRPI) incidence in a coronary care unit. The Journal of Nursing, 65(3), 80–87.] https://doi.org/10.6224/JN.201806_65(3).11
吳純怡、陳瑞貞(2017).運用皮膚照護群組預防非侵襲性正壓呼吸器之臉部壓傷.台灣醫學,21(4),399–405。[Wu, C. Y., & Chen, J. C. (2017). SSKIN care bundle as a standard procedure to prevent facial pressure injuries in patients with noninvasive positive pressure ventilators. Formosan Journal of Medicine, 21(4), 399–405.] https://doi.org/10.6320/FJM.2017.21(4).9
林靜秀、黃淑娟(2017).降低加護病房氧氣治療病人臉部皮膚壓瘡發生率.長庚護理,28(1),34–46。[Lin, C. H., & Huang, S. C. (2017). Reduce the incidence of facial pressure sore caused by oxygen therapy in the intensive care unit. Chang Gung Nursing, 28(1), 34–46.] https://doi.org/10.3966/102673012017032801004
廖淑貞、張文忠、游曉蕙、蘇瑜鵑、蔡雅琪、陳尹甄(2016).比較兩種固定方案對氣管插管相關性壓瘡之預防成效.健康與建築雜誌,3(2),49–55。[Liao, S. C., Chang, W. C., Yu, S. H., Su, Y. C., Tsai, Y. C., & Chen, Y. C. (2016). Comparison the effectiveness of two fixed methods for prevention endotracheal tube associated with pressure sore. Journal of Health and Architecture, 3(2), 49–55.] https://doi.org/10.6299/JHA.2016.3.2.R5.49
戴佳惠、許美玉(2016).敷料對使用非侵襲性正壓呼吸器病人顏面壓傷預防之成效.護理雜誌,63(5),86–94。[Tai, C. H., & Hsu, M. Y. (2016). Preventing facial pressure injuries in patients who use noninvasive positive pressure ventilators: The efficiency of dressings. The Journal of Nursing, 63(5), 86–94.] https://doi.org/10.6224/JN.63.5.86

被引用紀錄


江明珍、陳惠芳、朱育瑧(2023)。運用多元策略降低重症病人壓力性損傷發生率新臺北護理期刊25(2),66-76。https://doi.org/10.6540/NTJN.202309_25(2).0006
Mei-Ling Chen、Chang-Sheng Lin(2024)。Effectiveness of Polyurethane Foam Dressing Pads in Preventing Pressure Injuries Caused by Non-Invasive Positive Pressure Ventilation秀傳醫學雜誌23(3),315-324。https://doi.org/10.30185/SCMJ.202412_23(3).0002

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