提升腦損傷重症病人壓力性損傷癒合率

本專案旨在提升腦損傷重症病人壓力性損傷癒合率。壓力性損傷是腦損傷重症病人照護上常見的問題，也是臨床成效指標之一，若無完善的照護，不僅會延長癒合時間，更可能會伴隨傷口感染，延長住院時間，甚至造成死亡。本單位2018年癒合率為26.08%，較近3年平均癒合率35.06%下降8.98%，因此觸發執行專案改善之動機。經分析後確立問題為：護理人員壓力性損傷知能不足、壓力性損傷分級評估工具不足、缺乏癒合結案機制及缺乏跨團隊合作。過程中經由在職教育、壓力性損傷測量工具及辨識圖卡運用、增加壓力性損傷專責人員建立固定稽核制度及跨團隊溝通模式的建立，壓力性損傷癒合率由26.08%提升至41.03%。除達目標值外，專案確實提高護理人員壓力性損傷知能，讓病人得到完善且高品質之照護。

關鍵字

壓力性損傷；癒合率；腦損傷

並列摘要

Pressure injuries pose a common challenge in the care of critically ill patients with brain injuries, constituting a significant Clinical Performance Indicator. Inadequate management not only results in delayed healing but also elevates the risk of serious infections, prolonged hospital stays, and even mortality. In 2018, our pressure injury healing rate stood at 26.08%, notably lower than the three-year average of 35.06%. Upon analysis, identified issues included a lack of knowledge and proficiency among nursing personnel in managing pressure injuries, deficiencies in assessment tools for classifying such injuries, a mechanism for healing and case closure, and insufficient teamwork collaboration. To address these challenges, a special project was initiated in April 2019. The project employed in-service education, pressure injury assessment tools, and identification graph cards. Additionally, a regular auditing system for designated pressure injury personnel was implemented, and a cross-team communication model was established. As a result of these interventions, the healing rate of pressure injuries increased from 26.08% to 41.03%. This special project significantly improved nursing personnel's knowledge and proficiency in pressure injury treatment, particularly in severe cases with brain injuries.

並列關鍵字

pressure injury ； healing rate ； brain injury

參考文獻

李麗明、柯及婷、白菁滿、李英芬(2012)．提升某病房長期臥床病人壓瘡傷口癒合率之改善方案．馬偕護理雜誌，6 (1)，24-35。[Li, L. M., Ke, C. T., Bai, J. M., & Li, I. F. (2012). Improving healing of pressure ulcers in bed-ridden medical inpatients. Journal of MacKay Nursing, 6(1), 24-35.] https://doi.org/10.29415/jmkn.201201_6(1).0003

Bazali ski, D., Midura, B., Wójcik, A., & Wi ch, P. (2021). Selected biochemical blood parameters and a risk of pressure ulcers in patients receiving treatment in intensive care units. Medicina (Kaunas), 57(2). https://doi.org/10.3390/medicina57020177

Claure-Del Granado, R., & Mehta, R. L. (2016). Fluid overload in the ICU: Evaluation and management. Biomed Central Nephrology , 17(1), 109. https://doi.org/10.1186/s12882-016-0323-6

Cornish, L. (2017). The use of prophylactic dressings in the prevention of pressure ulcers: A literature review. British Journal of Community Nursing, 22(Sup6), S26-S32. https://doi.org/10.12968/bjcn.2017.22.Sup6.S26

Cox, J., & Rasmussen, L. (2014). Enteral nutrition in the prevention and treatment of pressure ulcers in adult critical care patients. Critical Care Nurse, 34(6), 15-27. https://doi.org/10. 4037/ccn2014950

主題瀏覽