Clever Kimberly, Smith Gloria, Bowser Carol, Monroe Kurt
Long-Term Care Unit, Fulton County Medical Center, McConnellsburg, PA 17233, USA.
Ostomy Wound Manage. 2002 Dec;48(12):60-7.
Skin breakdown is a common adverse occurrence in healthcare facilities; effective management of related risk factors is critical for prevention. Measures focusing on the skin care of patients with incontinence are recommended to reduce the incidence of pressure ulcers on the sacrum and ischium. However, little research exists to support these recommendations. A retrospective study was conducted to determine if the use of a skin cleansing/protectant product on residents with incontinence decreased the incidence of nosocomial pressure ulcers in the sacral/buttock area. Chart data from all residents with incontinence of a 57-bed, long-term care, skilled nursing home that employs a comprehensive approach to pressure ulcer prevention were collected for a period of 3 months before use of the new product and for 3 months following introduction of the new product. During the first 3 months, five (14.7%) of the 34 incontinent residents developed superficial pressure ulcers (20% were Stage I, 80% were Stage II). Following the change in skin care, no pressure ulcers occurred in the 30 residents with incontinence. The observed decrease (McNemar's chi-square = 4.786, df = 1, Phi = -.273, P =.015) suggests a significant association between the consistent application of a skin protectant and the prevention of skin breakdown. The results of this study demonstrate that, in this population, and in the presence of a comprehensive pressure ulcer prevention program, use of this skin protectant can significantly reduce the incidence of nosocomial sacral/buttocks pressure ulcers.
皮肤破损是医疗机构中常见的不良事件;有效管理相关风险因素对预防至关重要。建议采取措施关注失禁患者的皮肤护理,以降低骶骨和坐骨部位压疮的发生率。然而,几乎没有研究支持这些建议。开展了一项回顾性研究,以确定对失禁居民使用皮肤清洁/保护产品是否能降低骶骨/臀部区域医院获得性压疮的发生率。收集了一家拥有57张床位、采用综合压疮预防方法的长期护理专业疗养院中所有失禁居民在使用新产品前3个月和引入新产品后3个月的病历数据。在最初的3个月里,34名失禁居民中有5名(14.7%)出现了浅表性压疮(20%为I期,80%为II期)。皮肤护理改变后,30名失禁居民未发生压疮。观察到的下降情况(McNemar卡方检验=4.786,自由度=1,Phi=-0.273,P=0.015)表明持续使用皮肤保护剂与预防皮肤破损之间存在显著关联。这项研究的结果表明,在这一人群中,并且在存在综合压疮预防计划的情况下,使用这种皮肤保护剂可显著降低医院获得性骶骨/臀部压疮的发生率。