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医疗器械相关压力性损伤:澳大利亚一家急性三级医院的探索性描述性研究。

Medical device-related pressure injuries: An exploratory descriptive study in an acute tertiary hospital in Australia.

作者信息

Barakat-Johnson Michelle, Barnett Catherine, Wand Timothy, White Kathryn

机构信息

Sydney Nursing School, The University of Sydney and Sydney Local Health District, Patient Safety and Quality, Level 7, KGV, Royal Prince Alfred Hospital, Missenden Road, Camperdown, Australia.

Sydney Nursing School, The University of Sydney and Sydney Local Health District, The Cancer Nursing Research Unit, Lifehouse, Missenden Road, Camperdown, Australia.

出版信息

J Tissue Viability. 2017 Nov;26(4):246-253. doi: 10.1016/j.jtv.2017.09.008. Epub 2017 Oct 4.

Abstract

AIM

To examine and explore medical device-related pressure injuries in an 800-bed tertiary hospital.

MATERIALS AND METHODS

An exploratory descriptive study design was employed. A prospective review of all data on reported hospital-acquired pressure injuries was conducted on a weekly basis from July 2015 to August 2016. This included a patient assessment and medical record review as well as brief semi-structured interviews with nurses.

RESULTS

The overall incidence of medical device-related pressure injuries was 27.9% (50/179) with the majority (68%, 34/50) occurring in intensive care. The most common cause of a medical device-related pressure injury was oxygen tubing behind ears (n = 21) and endotracheal tubes (n = 13). Nurses were unaware of the implications of medical devices in contact with the skin and patient medical records did not present a valuable source of information in relation to pressure injury prevention.

CONCLUSION

Medical device-related pressure injuries were represented in 27.9% of our entire patient cohort; primarily occurring on the ear from oxygen tubing and on the mouth from endotracheal tubes in patients in intensive care. Additional support, education and monitoring for nurses at a local level on the prevention of medical device-related pressure injuries is necessary to prevent their occurrence. Furthermore, consensus on the classification and reporting of medical device-related pressure injuries is still in development, making reporting and monitoring challenging. Medical device-related pressure injuries are a continuing clinical issue that require further exploration.

摘要

目的

在一家拥有800张床位的三级医院中检查和探究与医疗器械相关的压力性损伤。

材料与方法

采用探索性描述性研究设计。对2015年7月至2016年8月期间报告的所有医院获得性压力性损伤数据进行前瞻性每周审查。这包括患者评估、病历审查以及对护士的简短半结构化访谈。

结果

与医疗器械相关的压力性损伤的总体发生率为27.9%(50/179),其中大多数(68%,34/50)发生在重症监护病房。与医疗器械相关的压力性损伤最常见的原因是耳后氧气管(n = 21)和气管内导管(n = 13)。护士未意识到与皮肤接触的医疗器械的影响,并且患者病历对于预防压力性损伤而言并非有价值的信息来源。

结论

在我们整个患者队列中,与医疗器械相关的压力性损伤占27.9%;主要发生在重症监护病房患者的耳部,由氧气管引起,以及口腔部,由气管内导管引起。有必要在地方层面为护士提供关于预防与医疗器械相关的压力性损伤的额外支持、教育和监测,以防止其发生。此外,关于与医疗器械相关的压力性损伤的分类和报告的共识仍在形成中,这使得报告和监测具有挑战性。与医疗器械相关的压力性损伤是一个持续存在的临床问题,需要进一步探索。

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