降低加護病房病患壓瘡發生率之改善方案

The Improvement Scheme for Reduce the Pressure Sore Incidence of Patient in the Intensive Care Unit

陳真慧(Chen-Hui Chen) ； 鄭玉玲(Yu-Ling Cheng) ； 陳雅紅(Ya-Hung Chen) ； 洪彩雲(Tase-Yun Horng) ； 李華蘭(Han-Lan Li) ； 陶耀華(Yaw-Hua Tau)

《源遠護理》 1卷3期 (2007/11) Pp. 34-47

https://doi.org/10.6530/YYN.2007.1(3).04

摘要

醫療品質漸被重視，壓瘡是護理品質的重要指標。本單位93年7~12月病患壓瘡發生率高之主要原因：護理人力不足、對壓瘡照護無一致之標準、未對壓瘡高危險群病患做評估及預防。經查檢護理人員對壓瘡照護之正確率僅75%，並以問卷調查發現：對壓瘡預防行為之正確率僅62%、46%護理人員有正確預防壓瘡知識。本專案藉由：調整適當護理人力，制訂正確壓瘡照護標準、翻身標準作業流程及制訂「壓瘡高危險群病患篩檢表」，成立壓瘡照護稽核小組，以降低病患壓瘡發生率。實施結果為：94年5-10月壓瘡發生率由1.47%降至0.67%，護理人員對壓瘡照護正確率達94%，且對預防壓瘡認知提升至96%、預防行為之正確率達95%，其推行之成效顯著。本專案所制訂之標準作業流程及壓瘡高危險群病患篩檢表，已由護理部品質委員會審核後，推行至全院，以落實正確之壓瘡照護。

關鍵字

壓瘡 ； 照護標準 ； 標準作業流程

並列摘要

Pressure sore is one of the major indicators that demonstrate quality of medical and nursing care. A study conducted in an intensive care unit (ICU) in a metropolitan hospital in Taiwan from July to December 2004 indicated that three major factors contributed to the high incidence of pressure sore were (1) nursing manpower shortage, (2) lack of standard of care, and (3) lack of assessment and prevention of high-risk population. This study also showed that 75% of the nurses provided appropriate care, and 62% knew the correct procedures to prevent pressure sore, but only 46% had accurate knowledge in the prevention of pressure sores.
The strategies to reduce the pressure sore rate included (1) increasing the nursing patient ratio, (2) establishing a standard of care for pressure sore, including patient turning protocol, (3) implementing an assessment tool to identify ”high-risk” patients and (4) establishing a pressure sore surveillance team.
The post-implementation audit from May to October 2005 showed that the pressure sore incidence decreased from 1.47% to 0.67%. The accuracy in nursing care increased from 75% to 94%. The nurses' knowledge in the recognition of pressure sore prevention increased from 46% to 96%. Proper nursing procedures in preventive care increased from 62% to 95%. This project significantly improved the quality of care in the ICU. The pressure sore standard of care and the assessment tool have been implemented throughout the hospital.

並列關鍵字

pressure sore ； nursing care standard ； standard of care