降低中風及神經科加護病房壓傷發生率

壓傷是臨床護理品質重要指標，統計本單位2016年1-7月壓傷發生率有居高不下趨勢；壓傷容易延長住院日數，甚至家屬抱怨，並增加護理及醫療成本而引發動機。本專案目的為降低中風及神經加護病房壓傷發生率。經現況分析問題：有缺乏持續性的Braden壓傷危險因子評估系統、護理人員對於預防壓傷認知及執行預防壓傷行為不足、缺乏導管固定相關減壓之標準流程及減壓相關輔助產品、減壓設備老舊、功能不佳及缺乏定期稽核制度等。擬定改善方案為修訂Braden壓傷危險因子評估時機、舉辦在職教育、導管固定標準減壓流程及相關產品使用、增設減壓床墊等。經介入方案後，壓傷發生率由2.76%下降至0.08%，有顯著成效。期望藉此專案，進而提升護理照護品質。

關鍵字

壓力性損傷；壓傷發生率；中風及神經加護病房； Braden壓傷危險因子評估

並列摘要

Pressure injury is a quality indicator in healthcare units, resulting in prolonged hospitalization, elevated medical costs, worsen care quality, and increased dissatisfaction of patients and the family caregivers. The incidence rates of pressure injury among patients in a stroke and neurological intensive care unit has gradually increased. This article aims to investigate and implement a project with to reduce the incidence of pressure injuries in stroke and neurological intensive care units (ICU). Data analyzed from January to July 2021 revealed high incident rate of pressure injury in ICU, low relevant correctness of related knowledge among nurses, and low performed accuracy of pressure injury care. Such poor pressure injury prevention was attributable to nurses' insufficient knowledge and skills of prevention, a lack of regulations, audit systems, and assessment tools, and also improper equipment for catheter fixation, particularly associated with decompression and its auxiliary products. A project was implemented from September 2016 to August 2017 and strategies were made to revise the tool of risk factor evaluation, increase educational training, establish care regulations and standard procedures, leading to a significant reduce of the incidence rate from 2.76% to 0.08%. We suggest to implement this project to other clinical unites for better generalizability to reduce pressure injury and optimize patient quality care.

並列關鍵字

pressure injury ； pressure injury incidence rate ； stroke and neuro intensive care unit ； Braden risk factor evaluation

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