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预测老年住院患者医院获得性压疮的因素。

Predictors of hospital-acquired pressure ulcers among older adult inpatients.

机构信息

Department of Neurology, Konkuk University Medical Center, Seoul, South Korea.

Department of Quality Improvement, Konkuk University Medical Center, Seoul, South Korea.

出版信息

J Clin Nurs. 2018 Oct;27(19-20):3780-3786. doi: 10.1111/jocn.14600. Epub 2018 Aug 3.

Abstract

AIM AND OBJECTIVES

To provide basic information on the preventive care for pressure ulcer (PU) by analysing PU-related characteristics and identifying PU predictors.

BACKGROUND

The incidence of PUs in hospitals is increasing, and continuous PU management is required. The occurrence of PU was an important standard for hospital certification. There is a need to identify predictors of PUs for proper management of PUs.

DESIGN

This is a descriptive study that analyses the electronic medical records of a university hospital.

METHODS

Of all older adult inpatients aged over 65 years admitted to the hospital (from January 1, 2011-December 31, 2015), 34,287 were included in this study. To identify the PU predictors, a logistic regression analysis was performed using IBM SPSS Statistics 24.

RESULTS

Predictors influencing PU were gender (OR = 1.36, 95% CI = 1.03-1.05), age, (OR = 1.04, 95% CI = 1.03-1.05), admission method (OR = 0.39, 95% CI = 0.32-0.46), consciousness status (OR = 3.77, 95% CI = 1.83-7.77) and Braden Scale score (OR = 0.07, 95% CI = 0.69-0.72). Among the predictors, consciousness is the most important variable. Patients who are drowsy were 3.77 times more likely to develop PU than those who are alert.

CONCLUSIONS

To prevent and manage PU, the level of consciousness of older adult patients who are hospitalised should be assessed, and appropriate interventions should be provided.

RELEVANCE TO CLINICAL PRACTICE

Pressure ulcer-specific interventions should be provided systematically by healthcare providers to those with altered consciousness beginning at hospital admission.

摘要

目的和目标

通过分析压疮(PU)相关特征并确定压疮预测因素,提供预防保健的基本信息。

背景

医院中 PU 的发病率不断上升,需要持续进行 PU 管理。PU 的发生是医院认证的一个重要标准。因此,有必要确定 PU 的预测因素,以便对 PU 进行适当管理。

设计

这是一项描述性研究,分析了一所大学医院的电子病历。

方法

纳入 2011 年 1 月 1 日至 2015 年 12 月 31 日期间年龄在 65 岁以上的所有老年住院患者 34287 例。为了确定 PU 的预测因素,使用 IBM SPSS Statistics 24 进行逻辑回归分析。

结果

影响 PU 的预测因素为性别(OR=1.36,95%CI=1.03-1.05)、年龄(OR=1.04,95%CI=1.03-1.05)、入院方式(OR=0.39,95%CI=0.32-0.46)、意识状态(OR=3.77,95%CI=1.83-7.77)和Braden 量表评分(OR=0.07,95%CI=0.69-0.72)。在这些预测因素中,意识状态是最重要的变量。昏睡的患者发生 PU 的可能性是清醒患者的 3.77 倍。

结论

为了预防和管理 PU,应评估住院老年患者的意识水平,并提供适当的干预措施。

临床意义

医护人员应从患者入院开始,针对意识改变的患者系统地提供压疮特异性干预措施。

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