Gobbi Paola
Direzione Sanitaria, Ospedale di Garbagnate Milanese, MI.
Assist Inferm Ric. 2002 Jan-Mar;21(1):22-7.
Patients may develop a pressure sore while in hospital, but some are admitted with a pressure sore. In Garbagnate hospital all patients are assessed for the risk of pressure sores. The ad hoc forms of patients with multiple lesions, in very poor conditions and with "sentinel" symptoms such as poor hygiene, malnutrition, bruises, are specifically assessed and further data from the head nurse and the family are collected to understand and reconstruct the patients' stories. From January 1999, 26 patients with pressure sores were admitted; 80% were over 75 years: 42.4% came from their homes and 7 from nursing homes. Half of the patients presented severe malnutrition. All the cases had some common characteristics: lack of well defined management of pressure sores; delays in the requests for special mattresses due to lack of attention or bureaucratic problems; or use of ineffective treatments or medications; lack of contacts between hospital and district, leading to a fragmented patient care. Two of the 26 cases are presented and their significance discussed in details.
患者可能在住院期间出现压疮，但有些患者入院时就已有压疮。在加尔巴尼亚特医院，所有患者都要接受压疮风险评估。对于有多处损伤、身体状况极差且有诸如卫生条件差、营养不良、瘀伤等“警示”症状的患者，会使用专门表格进行详细评估，并从护士长和患者家属处收集更多数据，以了解并梳理患者的情况。自1999年1月起，有26例压疮患者入院；其中80%年龄超过75岁：42.4%来自家中，7例来自养老院。半数患者存在严重营养不良。所有病例都有一些共同特征：压疮管理缺乏明确规范；因缺乏关注或官僚作风问题导致特殊床垫申请延误；或使用无效的治疗方法或药物；医院与社区之间缺乏沟通，导致患者护理碎片化。现展示26例病例中的两例，并详细讨论其意义。
