Pressure Injury Prevention and Management, Sydney Local Health District, Sydney, New South Wales, Australia.
Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
Int Wound J. 2019 Apr;16(2):424-432. doi: 10.1111/iwj.13051. Epub 2018 Dec 17.
This pilot study aimed to evaluate the clinical efficacy and feasibility of a fluidised positioning device to reduce occipital pressure injuries (PIs). A post-test design with a historical control group was used in a 54-bed intensive care unit between September 2017 and August 2018. Patients who were receiving either extracorporeal membrane oxygenation, were mechanically ventilated, or had raised intracranial pressure (≥20) were recruited. The intervention consisted of a fluidised positioning device under the patient's head, and a skin assessment every 8 h. Outcome measures included the occurrence of occipital PIs and registered nurses (RNs)' perspectives of the intervention. Data collected from patients in the intervention group were compared with data obtained from the historical control group between May 2016 and April 2017. Sixty-four patients were recruited in the intervention phase and 63 were in the historical control group. Results showed a statistically significant reduction in occipital PIs by 87.7% (16/63; 25.4% historical control vs 2/64; 3.13% interventional group). Bedside RNs provided positive evaluation of the fluidised positioning device. The findings demonstrate that the fluidised positioning device is a feasible and effective intervention in reducing the risk of occipital PIs in intensive care patients, which merits the continuation of use and further evaluation through a larger-scale study.
本初步研究旨在评估流体定位装置在降低枕部压疮（PI）风险方面的临床疗效和可行性。在 2017 年 9 月至 2018 年 8 月期间，我们在一个有 54 张床位的重症监护病房中采用了后测设计和历史对照研究。纳入的患者需接受体外膜肺氧合、机械通气或颅内压升高（≥20mmHg）。干预措施包括在患者头部下方放置一个流体定位装置，并每 8 小时进行一次皮肤评估。观察指标包括枕部 PI 的发生情况和注册护士（RN）对干预措施的看法。干预组患者的数据与 2016 年 5 月至 2017 年 4 月期间的历史对照组数据进行了比较。干预组纳入了 64 例患者，历史对照组纳入了 63 例患者。结果显示，枕部 PI 的发生率显著降低了 87.7%（16/63；历史对照组为 25.4%，干预组为 3.13%）。床旁 RN 对流体定位装置的评价是积极的。研究结果表明，流体定位装置是一种可行且有效的干预措施，可降低重症监护患者发生枕部 PI 的风险，值得进一步使用和通过更大规模的研究进行评估。
