Rosen Jules, Mittal Vikas, Degenholtz Howard, Castle Nick, Mulsant Benoit H, Nace David, Rubin Fred H
Western Psychiatric Institute and Clinic, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Adv Skin Wound Care. 2006 Jun;19(5):262-8. doi: 10.1097/00129334-200606000-00011.
To determine if educating nursing home staff about pressure ulcer prevention reduces the differential risk of pressure ulcer development in black and white nursing home residents.
Subanalysis of a study designed to monitor the emergence of all pressure ulcers in nursing home residents during 12-week baseline and intervention periods.
All residents and staff of a not-for-profit, 136-bed nursing home in urban western Pennsylvania.
The quality improvement intervention, featuring a computer-based interactive video education program on pressure ulcer prevention and early detection, consisted of 3 components: (1) staff ability enhancement, (2) staff financial incentives, and (3) real-time management feedback. Three specific outcome measures were monitored for differential risk of pressure ulcer development in black and white nursing home residents: (1) the rate of emergent Stage I-IV pressure ulcers identified, (2) the rate of emergent Stage II-IV pressure ulcers identified, and (3) the rate of individual residents developing at least 1 pressure ulcer (Stages II-IV).
At baseline, black residents demonstrated a higher rate of Stage II-IV pressure ulcer emergence. Black residents with any pressure ulcer were also more likely to have multiple Stage II pressure ulcers compared with white residents. During the baseline period, 31.8% of the pressure ulcers detected in white residents were Stage I, whereas no Stage I pressure ulcers were detected in black residents. During the intervention period, the rate of emergence of all pressure ulcers declined for both groups in similar trends.
Black residents were more likely to have multiple Stage II-IV pressure ulcers and were less likely to have Stage I pressure ulcers identified at baseline compared with white residents. The education intervention effectively reduced the rate of pressure ulcers for all residents and eliminated the racial disparity noted during the baseline period.
确定对养老院工作人员进行压疮预防教育是否能降低黑人和白人养老院居民发生压疮的差异风险。
对一项旨在监测养老院居民在12周基线期和干预期内所有压疮出现情况的研究进行子分析。
宾夕法尼亚州西部城市一家拥有136张床位的非营利性养老院的所有居民和工作人员。
质量改进干预措施以基于计算机的压疮预防和早期检测交互式视频教育项目为特色，包括3个组成部分：（1）工作人员能力提升，（2）工作人员经济激励，（3）实时管理反馈。监测了三项具体结局指标，以评估黑人和白人养老院居民发生压疮的差异风险：（1）已识别的I-IV期新发压疮发生率，（2）已识别的II-IV期新发压疮发生率，（3）至少发生1处压疮（II-IV期）的居民个体发生率。
在基线期，黑人居民II-IV期压疮的发生率较高。与白人居民相比，患有任何压疮的黑人居民也更有可能出现多处II期压疮。在基线期，白人居民中检测到的压疮有31.8%为I期，而黑人居民中未检测到I期压疮。在干预期，两组所有压疮的发生率均以相似趋势下降。
与白人居民相比，黑人居民在基线期更有可能出现多处II-IV期压疮，且识别出I期压疮的可能性较小。教育干预有效降低了所有居民的压疮发生率，并消除了基线期存在的种族差异。
