Edsberg Laura E, Langemo Diane, Baharestani Mona Mylene, Posthauer Mary Ellen, Goldberg Margaret
Laura E. Edsberg, PhD, Director, Center for Wound Healing Research, Natural & Health Sciences Research Center, Associate Professor Natural Sciences Department, Daemen College, Amherst, New York. Diane Langemo, PhD, RN, FAAN, Adjunct Faculty, University of North Dakota College of Nursing, Grand Forks. Mona Mylene Baharestani, PhD, APN, CWON, FACCWS, Associate Chief, Wound Care & Research Programs, James H. Quillen Veterans Affairs Medical Center, Johnson City (Mountain Home), Tennessee, and Clinical Associate Professor, Quillen College of Medicine, Department of Surgery, Johnson City, Tennessee. Mary Ellen Posthauer, BS, RDN, President, MEP Healthcare Dietary Services, Inc, Evansville, Indiana. Margaret Goldberg, MSN, RN, CWOCN Wound Care Consultant, Delray Wound Treatment Ctr, Delray Beach, Florida.
J Wound Ostomy Continence Nurs. 2014 Jul-Aug;41(4):313-34. doi: 10.1097/WON.0000000000000050.
In the vast majority of cases, appropriate identification and mitigation of risk factors can prevent or minimize pressure ulcer (PU) formation. However, some PUs are unavoidable. Based on the importance of this topic and the lack of literature focused on PU unavoidability, the National Pressure Ulcer Advisory Panel hosted a multidisciplinary conference in 2014 to explore the issue of PU unavoidability within an organ system framework, which considered the complexities of nonmodifiable intrinsic and extrinsic risk factors. Prior to the conference, an extensive literature review was conducted to analyze and summarize the state of the science in the area of unavoidable PU development and items were developed. An interactive process was used to gain consensus based on these items among stakeholders of various organizations and audience members. Consensus was reached when 80% agreement was obtained. The group reached consensus that unavoidable PUs do occur. Consensus was also obtained in areas related to cardiopulmonary status, hemodynamic stability, impact of head-of-bed elevation, septic shock, body edema, burns, immobility, medical devices, spinal cord injury, terminal illness, and nutrition.
在绝大多数情况下，对危险因素进行恰当识别和缓解可预防压疮（PU）形成或使其影响降至最低。然而，有些压疮是不可避免的。鉴于该主题的重要性以及缺乏聚焦于压疮不可避免性的文献，国家压疮咨询小组于2014年主办了一次多学科会议，以在器官系统框架内探讨压疮不可避免性问题，该框架考虑了不可改变的内在和外在危险因素的复杂性。会议召开前，进行了广泛的文献综述，以分析和总结不可避免的压疮发生领域的科学现状并拟定相关条目。采用互动过程，以使各组织的利益相关者和与会成员就这些条目达成共识。当获得80%的一致意见时即达成共识。该小组达成共识，即不可避免的压疮确实会发生。在与心肺状况、血流动力学稳定性、床头抬高的影响、感染性休克、身体水肿、烧伤、活动障碍、医疗器械、脊髓损伤、晚期疾病及营养等相关领域也达成了共识。
