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一项评估护理人员对预防与医疗设备相关压力性损伤的认知及干预措施的前瞻性描述性研究。

A Prospective, Descriptive Study to Assess Nursing Staff Perceptions of and Interventions to Prevent Medical Device-related Pressure Injury.

作者信息

Karadag Ayişe, Hanönü Seval C, Eyikara Evrim

机构信息

Koç University School of Nursing, Istanbul, Turkey.

Gazi University Institute of Health Sciences, Department of Nursing, Ankara, Turkey.

出版信息

Ostomy Wound Manage. 2017 Oct;63(10):34-41.

Abstract

Nurses play an important role in identifying patients at risk for medical device-related (MDR) pressure injuries and preventing their occurrence. A prospective, descriptive study was conducted across 6 hospitals in Ankara, Turkey between December 2014 and June 2015 to assess nursing perceptions about and interventions used for the pre- vention of MDR pressure ulcers. A questionnaire was used to collect demographic information and data on experience with MDR pressure ulcers; in addition, participants completed a Nursing Interventions Form that included 10 statements regarding basic nursing interventions to prevent MDR pressure ulcers; answer options were I perform, I partly perform, I do not perform. Of the 1555 nurses invited, 606 (38%) participated. Nurses who chose to volunteer completed the study instruments independently at their convenience; their responses were entered directly into the statistical analysis system by the researchers. Demographic and interventions data were analyzed using frequency and percentage distributions. Participant mean age was 30.0 ± 6.83 years, most were women (86.9%), with a mean of 8.47 ± 6.70 years of experience. Most had a bachelor's degree (55.1%), 38.2% worked in intensive care units, 50.2% participated in a scienti c program regarding the prevention/treatment of pressure ulcers after their gradu- ation, and 87.9% provided care to patients with pressure ulcers. A great majority (80.1%) of the nurses believed the use of medical devices can lead to pressure ulcers and 59.2% had experience with MDR pressure ulcers, but almost 20% did not believe medical devices can cause a pressure ulcer. The nurses identi ed 18 medical devices that posed the highest risk of causing MDR pressure ulcers; the 3 most commonly identi ed devices were endotracheal tubes (59.7%), tracheostomy ties (58.9%), and blood pressure cuffs (58.4%). The most common interventions used by these nurses included ensuring correct device positioning (87.9%) and loosening devices at least once every shift (80%) when medical conditions allowed. These ndings suggest nurses may not be aware of the risk for pressure ul- cers associated with a number of medical devices, indicating a need for comprehensive inservice training programs and research to identify optimal measures and methods to prevent MDR pressure ulcers.

摘要

护士在识别有医疗器械相关(MDR)压力性损伤风险的患者并预防其发生方面发挥着重要作用。2014年12月至2015年6月期间,在土耳其安卡拉的6家医院开展了一项前瞻性描述性研究,以评估护士对预防MDR压疮的看法及所采用的干预措施。通过问卷调查收集人口统计学信息以及有关MDR压疮的经验数据;此外,参与者填写了一份护理干预表格,其中包含10条关于预防MDR压疮的基本护理干预措施的陈述;回答选项为“我执行”“我部分执行”“我不执行”。在受邀的1555名护士中,606名(38%)参与了研究。选择自愿参与的护士在方便的时候独立完成研究工具;研究人员将他们的回答直接录入统计分析系统。使用频率和百分比分布对人口统计学和干预措施数据进行分析。参与者的平均年龄为30.0±6.83岁,大多数为女性(86.9%),平均工作经验为8.47±6.70年。大多数拥有本科学历(55.1%),38.2%在重症监护病房工作,50.2%在毕业后参加过关于预防/治疗压疮的科学项目,87.9%为有压疮的患者提供护理。绝大多数(80.1%)护士认为使用医疗器械会导致压疮,59.2%有MDR压疮的护理经验,但近20%不认为医疗器械会导致压疮。护士们识别出18种导致MDR压疮风险最高的医疗器械;最常被识别出的3种器械是气管内导管(59.7%)、气管切开系带(58.9%)和血压袖带(58.4%)。这些护士最常用的干预措施包括确保器械正确放置(87.9%)以及在病情允许时每班至少松开器械一次(80%)。这些研究结果表明,护士可能并未意识到许多医疗器械会带来压疮风险,这表明需要开展全面的在职培训项目和研究,以确定预防MDR压疮的最佳措施和方法。

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