在急性护理医院使用压力伤害预防干预措施
Nora Warshawsky1, Angela Pascale, Jill Cox
1Nora Warshawsky is a nurse scientist and Angela Pascale is a research analyst at Press Ganey Associates, South Bend, IN. Jill Cox is a clinical professor of nursing and an advanced practice nurse at the Rutgers University School of Nursing, Newark, NJ. Virginia Capasso is an advanced practice nurse and nurse scientist at Massachusetts General Hospital, Boston, and an instructor in surgery at Harvard Medical School. Laura E. Edsberg is professor of natural sciences and director of the Center for Wound Healing Research at Daemen University, Amherst, NY. Contact author: Angela Pascale, angela.pascale@pressganey.com. The authors have disclosed no potential conflicts of interest, financial or otherwise.
护士表现出良好的压力损伤 (PI) 预防,但营养支持和重新定位需要改进. 在医院中保持一致的PI仍然是一个挑战,影响患者的生活质量和医疗保健成本.
科学领域:
- 护理质量指标护理质量指标
- 患者安全 患者安全
- 医疗保健管理的管理
背景情况:
- 压力损伤 (PIs) 是一个重要的临床问题,影响患者的福祉和增加医疗保健费用.
- 尽管进行了广泛的研究和建立了预防策略,但医院获得的压力损伤 (HAPI) 仍然是一个主要的临床挑战.
- 护理干预对PI预防至关重要,但HAPI继续影响住院患者.
研究的目的:
- 调查护士遵守压力伤害预防协议与HAPI发生之间的相关性.
- 分析与HAPI开发有关的特定预防干预措施的利用情况.
主要方法:
- 分析了2022年护理质量指标国家数据库 (NDNQI) 的数据,来自1379个急性护理机构.
- 包括355,031名高风险患者来评估PI流行率和预防性干预的使用.
- 在没有PI,肤浅PI和严重PI的患者组中比较了四个关键干预措施 (压力再分配,湿度管理,营养支持,重新定位),使用奇平方测试.
主要成果:
- 确定HAPI患病率为3.8%,其中13,500名高风险患者患有PI.
- 压力再分配和湿度管理干预措施在所有PI组中显示出高一致性 (91.9%-95.4%).
- 营养支持和例行重新定位的应用不太一致 (78.6%-90.4%),严重PI病例的干预使用率最高,表面PI病例的干预使用率最低.
结论:
- 在危险患者的医疗保健提供者中,一致遵守压力伤害预防实践是显而易见的.
- 加强预防策略的机会存在,特别是改善营养支持和例行重新定位的一致性.
- 这些领域的有针对性的改进可以进一步减少医院获得的压力损伤的发生率.
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