Salvadalena G D, Snyder M L, Brogdon K E
J ET Nurs. 1992 Sep-Oct;19(5):160-5.
Pressure ulcers in hospitalized patients represent a significant challenge to the health professionals who care for these patients. This challenge extends to the health care system as a whole because of the staggering costs associated with pressure ulcer resolution. Although the relative benefits of various treatment methods have long been debated, intervention before ulcer formation clearly stands as the most efficacious approach to this problem. The Braden Scale for Predicting Pressure Sore Risk, a recently developed paper tool, was evaluated in our acute care medical unit for its ability to predict pressure ulcer occurrence. The sensitivity of the Braden Scale in this evaluation was much lower than that reported in other published studies. The Braden Scale was less effective than the nurse judgment prediction method, the current prevailing prediction method at this institution. The gravity of these results, however, is unclear because of the questionable incidence of ulcers in this study, which may be artificially high due to permissive criteria used in the identification of stage 1 ulcers. We determined that the lack of unequivocally defined criteria for the identification of stage 1 ulcers may contribute to variance between studies. We also found that intervention measures were used only 27% of the time after the identification of patients at risk.
住院患者的压疮对护理这些患者的医护人员构成了重大挑战。由于压疮愈合相关的惊人成本，这一挑战扩展到了整个医疗保健系统。尽管长期以来一直在争论各种治疗方法的相对益处，但在溃疡形成前进行干预显然是解决这个问题最有效的方法。用于预测压疮风险的Braden量表是一种最近开发的纸质工具，我们在急性护理医疗单元对其预测压疮发生的能力进行了评估。在这次评估中，Braden量表的敏感性远低于其他已发表研究报告的水平。Braden量表不如护士判断预测方法有效，而护士判断预测方法是该机构目前普遍使用的预测方法。然而，由于本研究中溃疡发生率存疑，这些结果的严重性尚不清楚，该发生率可能因在识别1期溃疡时使用的宽松标准而人为偏高。我们确定，缺乏明确界定的1期溃疡识别标准可能导致研究之间存在差异。我们还发现，在识别出有风险的患者后，仅27%的时间采取了干预措施。
