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建立傷口照護標準-以壓瘡傷口爲例

Building Wound Care Standard Model-Patients Suffering from Pressure Ulcer

摘要


Pressure ulcers remain a significant problem in the acute and community health settings despite being largely preventable. It is a challenge for nurses to manage the wound care of pressure ulcers. The costs of treating established pressure ulcers are enormous. In addition, the pressure ulcers not only impact the afflicted individual's physical, psychological, and spiritual wholeness, but also increase the medical resources of the health care system. The purpose of this study was to explore the nurses' knowledge on wound care for pressure ulcers, provide training for nursing staff on wound care standards, and evaluate the nurses caregiving behaviors of pressure ulcers and the patient's outcomes of wound healing. There were 103 nurses (experimental group 61, control group 42) and 10 patients (5 in each group) enrolled into the study. The investigators developed a structured questionnaire on nurses' knowledge. An assessment scale of caregiving behavior in wound care was adopted to evaluate the patients' wound healing. Descriptive statistics, t test and analysis of covariate variances were used to analyze the data. The results showed that (1) there was a significant difference in the care of pressure wound between nurses whom received training and those did not (p<0.05), (2) there was also significant difference in knowledge of pressure wound and nurses clinical experience (p<0.05), and (3) the wound healing in the patients with standard wound care were better than those with conventional procedure care. In conclusion, the study results provide evidence for clinicians to establish wound care standards on pressure ulcers. It is expected that the model of wound care standards can enhance nurses' knowledge on the care of pressure ulcers. Furthermore, nursing administrators and educators could develop guidelines of wound care and the on-job training program for nurses based on the study results to improve the care quality of wound.

並列摘要


Pressure ulcers remain a significant problem in the acute and community health settings despite being largely preventable. It is a challenge for nurses to manage the wound care of pressure ulcers. The costs of treating established pressure ulcers are enormous. In addition, the pressure ulcers not only impact the afflicted individual's physical, psychological, and spiritual wholeness, but also increase the medical resources of the health care system. The purpose of this study was to explore the nurses' knowledge on wound care for pressure ulcers, provide training for nursing staff on wound care standards, and evaluate the nurses caregiving behaviors of pressure ulcers and the patient's outcomes of wound healing. There were 103 nurses (experimental group 61, control group 42) and 10 patients (5 in each group) enrolled into the study. The investigators developed a structured questionnaire on nurses' knowledge. An assessment scale of caregiving behavior in wound care was adopted to evaluate the patients' wound healing. Descriptive statistics, t test and analysis of covariate variances were used to analyze the data. The results showed that (1) there was a significant difference in the care of pressure wound between nurses whom received training and those did not (p<0.05), (2) there was also significant difference in knowledge of pressure wound and nurses clinical experience (p<0.05), and (3) the wound healing in the patients with standard wound care were better than those with conventional procedure care. In conclusion, the study results provide evidence for clinicians to establish wound care standards on pressure ulcers. It is expected that the model of wound care standards can enhance nurses' knowledge on the care of pressure ulcers. Furthermore, nursing administrators and educators could develop guidelines of wound care and the on-job training program for nurses based on the study results to improve the care quality of wound.

參考文獻


于博芮、李世代、林壽惠(2005)。台灣醫療院所壓瘡風險評估工具之臨床效度。台灣老年醫學雜誌。1(2),79-89。
台灣醫療品質策進會(2002)。急性照護的壓瘡。台北:台灣醫療品質策進會。
林慧姿、黃靜宜、黃素猜、張淑真(2007)。如何運用實證護理-以壓瘡傷口治療照護爲例。長期照護雜誌。11(2),211-217。
陳瀅淳(2001)。臨床護理人員在壓瘡傷口照護的認識、執行及相關因素之探討。國立台灣大學醫學院護理學研究所。
陳瀅淳、邱艷芬(2002)。壓瘡照護革命。護理雜誌。49(6),101-105。

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