Al-Otaibi Yasser K, Al-Nowaiser Noura, Rahman Arshur
General Department of Medical Services, Quality & Patient Safety, Riyadh, Saudi Arabia.
BMJ Open Qual. 2019 Feb 13;8(1):e000464. doi: 10.1136/bmjoq-2018-000464. eCollection 2019.
Hospital-acquired pressure injury is a common preventable condition. Our hospital is a 144-bed governmental hospital in the Kingdom of Saudi Arabia that was found to have a 7.5% prevalence of hospital-acquired pressure injury in 2016. The aim of the improvement project was to reduce the prevalence of pressure injuries in our hospital from 7.5% to below 4% by the end of 2017. Our strategy for improvement was based on the Institute for Healthcare Improvement Model for Improvement. The change strategy was based on implementing an evidence-based risk assessment tool and a bundled evidence-based pressure injury prevention (PIP) intervention termed PIP bundle. After implementing the change package, we observed a reduction in the prevalence of pressure injuries by 84% (RR 0.16;95% CI 0.07 to 0.3; p value <0.0001) over a period of 12 weeks, in addition to an improvement in the compliance of pressure injury risk assessment and PIP interventions. The use of an evidenced-based bundled approach to prevent hospital-acquired pressure injuries has resulted in a significant reduction in the rate of pressure injuries. Improvement results were sustainable. In addition, our outcome measure exhibited minimal variability.
医院获得性压力性损伤是一种常见的可预防疾病。我们医院是沙特阿拉伯王国一家拥有144张床位的政府医院,2016年发现医院获得性压力性损伤的患病率为7.5%。改进项目的目标是到2017年底将我院压力性损伤的患病率从7.5%降低到4%以下。我们的改进策略基于医疗保健改进研究所的改进模型。变革策略基于实施一种循证风险评估工具和一种名为压力性损伤预防(PIP)捆绑包的循证压力性损伤预防干预措施。实施该变革方案后,在12周的时间里,我们观察到压力性损伤的患病率降低了84%(相对危险度0.16;95%置信区间0.07至0.3;p值<0.0001),此外,压力性损伤风险评估和PIP干预措施的依从性也有所提高。采用循证捆绑方法预防医院获得性压力性损伤显著降低了压力性损伤的发生率。改进结果具有可持续性。此外,我们的结果指标显示出最小的变异性。