Irvin Candice, Sedlak Elizabeth, Walton Christine, Collier Susan, Bernhofer Esther I
Nursing Institute - Cleveland Clinic Hillcrest Hospital, Mayfield Heights, Ohio.
Office of Nursing Research and Innovation, Cleveland Clinic, Independence, Ohio.
J Am Assoc Nurse Pract. 2017 Apr;29(4):203-208. doi: 10.1002/2327-6924.12440. Epub 2017 Feb 8.
Hospital-acquired pressure injuries (HAPIs) continue to be a persistent problem in the acute care arena. The purpose of this retrospective quality improvement study was to examine if the introduction of nurse practitioners (NPs), as wound care consultants (WCCs), without other interventions, impacted the HAPI rates in a community hospital.
A retrospective, comparison design was used; 48 months of HAPI data (May 2010-2014) reported on the monthly National Database for Nursing Quality Indicators (NDNQI) survey was abstracted from hospital records. Data included the assessment of 10,752 patients and were divided into two groups for comparison: 24 months before and 24 months after NP hiring.
There was a strong, inverse correlation between the presence of NPs and number of patients with HAPIs (r = -0.73, p < .01), indicating that HAPI rates were significantly lower after NPs took on the role of WCCs. The odds of a HAPI occurring following introduction of the NP WCCs were 20% of the odds in the previous years.
Study findings suggest that NPs assuming a leadership role as WCCs may be instrumental in decreasing HAPI rates.
医院获得性压疮（HAPIs）在急性护理领域仍然是一个持续存在的问题。这项回顾性质量改进研究的目的是检验在没有其他干预措施的情况下，引入护士从业者（NPs）作为伤口护理顾问（WCCs）是否会影响社区医院的HAPIs发生率。
采用回顾性比较设计；从医院记录中提取了48个月（2010年5月至2014年）上报至全国护理质量指标数据库（NDNQI）月度调查的HAPIs数据。数据包括对10752名患者的评估，并分为两组进行比较：NPs受聘前24个月和受聘后24个月。
NPs的存在与HAPIs患者数量之间存在强烈的负相关（r = -0.73，p <.01），表明在NPs担任WCCs角色后，HAPIs发生率显著降低。引入NP WCCs后发生HAPI的几率是前几年几率的20%。
研究结果表明，NPs作为WCCs发挥领导作用可能有助于降低HAPIs发生率。
