School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Australian Catholic University, Banyo, Queensland, Australia.
Nursing Research and Practice Development Centre, The Prince Charles Hospital, Chermside, Queensland, Australia.
Int Wound J. 2018 Dec;15(6):985-992. doi: 10.1111/iwj.12965. Epub 2018 Aug 2.
This exploratory, descriptive study aimed to identify and describe the pressure injury preventative interventions prescribed by nurses following the assessment of a patient's pressure injury risk and to compare the prescribed interventions relative to the assessed risk level. A total of 200 inpatients in a tertiary Australian hospital were included. Patients' charts were audited within 24 hours of admission. Data collected included patient characteristics, pressure injury risk assessment score and level, and preventative interventions prescribed. Most patients were assessed as not being at risk, with the largest group of at-risk patients assessed as being at high risk. Some not-at-risk patients were prescribed interventions intended for those at risk, while prescription rates of preventative interventions recommended for those at any level of risk were variable (6%-64%). Significant associations were found between assessed pressure injury risk and preventative intervention prescription. Preventative intervention prescription was inadequate, potentially exposing some patients to pressure injury. However, the association between intervention prescription and risk level suggests that nurses are prescribing interventions relative to risk. A more structured approach to intervention prescription according to risk level, such as a care bundle, may help to improve nurses' preventative intervention prescription and ensure that all at-risk patients receive appropriate preventative interventions.
本探索性、描述性研究旨在确定和描述护士在评估患者压疮风险后开出的压疮预防干预措施,并根据评估的风险水平比较开出的干预措施。共纳入澳大利亚一家三级医院的 200 名住院患者。在入院后 24 小时内对患者的病历进行了审核。收集的数据包括患者特征、压疮风险评估评分和级别以及开出的预防干预措施。大多数患者被评估为没有风险,最大的风险患者群体被评估为高风险。一些没有风险的患者被开处了针对有风险患者的干预措施,而对于任何风险级别的患者推荐的预防干预措施的处方率各不相同(6%-64%)。评估的压疮风险与预防干预处方之间存在显著关联。预防干预处方不足,可能使一些患者面临压疮风险。然而,干预处方与风险水平之间的关联表明,护士根据风险开出干预措施。根据风险水平制定更结构化的干预处方方法,如护理包,可能有助于提高护士预防干预的处方率,并确保所有有风险的患者都接受适当的预防干预措施。