運用皮膚照護群組降低重症病人壓力性損傷發生率

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

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)

《榮總護理》 35卷4期 (2018/12) Pp. 364-372

https://doi.org/10.6142/VGHN.201812_35(4).0004

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。

關鍵字

皮膚照護群組 ； 加護病房 ； 壓損 ； 發生率

並列摘要

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.

並列關鍵字

skin care bundle ； intensive care unit ； pressure injury ； incidence rate

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