Department of Nursing Science, Charité-Universitätsmedizin Berlin, Berlin, Germany.
J Clin Nurs. 2010 Dec;19(23-24):3364-71. doi: 10.1111/j.1365-2702.2010.03389.x.
The objective of this study was to describe the relationship between the German National Expert Standard Pressure Ulcer Prevention and the pressure ulcer prevalence in German nursing homes and hospitals.
The patient outcome pressure ulcer does not only depend on individual characteristics of patients, but also on institutional factors. In Germany, National Expert Standards are evidence-based instruments that build the basis of continuing improvement in health care quality. It is expected that after having implemented the National Expert Standard Pressure Ulcer Prevention, the number of pressure ulcers should decrease in health care institutions.
The analysed data were obtained from two cross-sectional studies from 2004-2005.
A multilevel analysis was performed to show the impact of the National Expert Standard Pressure Ulcer Prevention on pressure ulcer prevalence.
A total of 41.5% of hospitals and 38.8% of the nursing homes claimed to use the National Expert Standard in the process of developing their local protocols. The overall pressure ulcer prevalence grade 2-4 was 4.7%. Adjusted for hospital departments, survey year and individual characteristics, there was no significant difference in the prevalence of pressure ulcers between institutions that refer to the National Expert Standard or those referring to other sources in developing their local protocols (OR=1.14, 95% CI=0.90-1.44).
There was no empirical evidence demonstrating that local protocols of pressure ulcer prevention based on the National Expert Standard were superior to local protocols which refer other sources of knowledge with regard to the pressure ulcer prevalence.
The use of the National Expert Standard Pressure Ulcer Prevention can neither be recommended nor be refused. The recent definition of implementation of Expert Standards should be mandatory for all health care institutions which introduce Expert Standards.
本研究的目的是描述德国国家专家标准压疮预防与德国疗养院和医院压疮发生率之间的关系。
患者结局性压疮不仅取决于患者个体特征，还取决于机构因素。在德国，国家专家标准是基于证据的工具，为医疗保健质量的持续改进奠定基础。预计在实施国家专家标准压疮预防后，医疗机构的压疮数量应减少。
分析的数据来自于 2004-2005 年的两项横断面研究。
采用多水平分析方法显示国家专家标准压疮预防对压疮发生率的影响。
共有 41.5%的医院和 38.8%的疗养院声称在制定当地方案时使用了国家专家标准。总体 2-4 级压疮发生率为 4.7%。调整医院科室、调查年份和个体特征后，参照国家专家标准或其他来源制定当地方案的机构之间压疮发生率无显著差异（OR=1.14，95%CI=0.90-1.44）。
没有经验证据表明，基于国家专家标准的压疮预防当地方案在压疮发生率方面优于参照其他知识来源的当地方案。
使用国家专家标准压疮预防既不能推荐也不能拒绝。最近对专家标准实施的定义应成为所有引入专家标准的医疗机构的强制性要求。
