Powers Jan
Jan Powers, PhD, RN, CCRN, CCNS, CNRN, NE-BC, FCCM, Parkview Health System, Fort Wayne, Indiana.
J Wound Ostomy Continence Nurs. 2016 Jan-Feb;43(1):46-50. doi: 10.1097/WON.0000000000000198.
We evaluated 2 methods for patient positioning on the development of pressure ulcers; specifically, standard of care (SOC) using pillows versus a patient positioning system (PPS). The study also compared turning effectiveness as well as nursing resources related to patient positioning and nursing injuries.
A nonrandomized comparison design was used for the study.
Sixty patients from a trauma/neurointensive care unit were included in the study. Patients were randomly assigned to 1 of 2 teams per standard bed placement practices at the institution. Patients were identified for enrollment in the study if they were immobile and mechanically ventilated with anticipation of 3 days or more on mechanical ventilation. Patients were excluded if they had a preexisting pressure ulcer.
Patients were evaluated daily for the presence of pressure ulcers. Data were collected on the number of personnel required to turn patients. Once completed, the angle of the turn was measured. The occupational health database was reviewed to determine nurse injuries.
The final sample size was 59 (SOC = 29; PPS = 30); there were no statistical differences between groups for age (P = .10), body mass index (P = .65), gender (P = .43), Braden Scale score (P = .46), or mobility score (P = .10). There was a statistically significant difference in the number of hospital-acquired pressure ulcers between turning methods (6 in the SOC group vs 1 in the PPS group; P = .042). The number of nurses needed for the SOC method was significantly higher than the PPS (P ≤ 0.001). The average turn angle achieved using the PPS was 31.03°, while the average turn angle achieved using SOC was 22.39°. The difference in turn angle from initial turn to 1 hour after turning in the SOC group was statistically significant (P < .0001). No nurse injuries were reported for either group during the study.
Findings suggest that assistive devices such as a PPS can be effective in achieving proper positioning of patients to prevent development of pressure ulcers.
我们评估了两种患者体位摆放方法对压疮形成的影响；具体而言，即使用枕头的标准护理（SOC）方法与患者体位摆放系统（PPS）。该研究还比较了翻身效果以及与患者体位摆放和护理损伤相关的护理资源。
本研究采用非随机对照设计。
纳入了来自创伤/神经重症监护病房的60名患者。根据该机构每个标准床位的安置惯例，患者被随机分配到两个小组中的一组。如果患者无法自主活动且预计需要机械通气3天或更长时间，则被纳入本研究。如果患者已有压疮，则被排除。
每天评估患者是否出现压疮。收集翻身所需护理人员数量的数据。翻身完成后，测量翻身角度。查阅职业健康数据库以确定护士受伤情况。
最终样本量为59例（SOC组 = 29例；PPS组 = 30例）；两组在年龄（P = 0.10）、体重指数（P = 0.65）、性别（P = 0.43）、Braden量表评分（P = 0.46）或活动能力评分（P = 0.10）方面无统计学差异。不同翻身方法导致的医院获得性压疮数量存在统计学显著差异（SOC组6例，PPS组1例；P = 0.042）。SOC方法所需护士数量显著高于PPS方法（P≤0.001）。使用PPS时的平均翻身角度为31.°03，而使用SOC时的平均翻身角度为22.39°。SOC组从初始翻身到翻身1小时后的翻身角度差异具有统计学意义（P < 0.0001））。研究期间两组均未报告护士受伤情况。
研究结果表明，诸如PPS之类的辅助设备在实现患者正确体位摆放以预防压疮形成方面可能是有效的。
