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老年人在住院的头 36 小时内的压疮发生率及预测因素。

Pressure injury prevalence and predictors among older adults in the first 36 hours of hospitalisation.

机构信息

Menzies Health Institute Queensland, The School of Nursing and Midwifery, Griffith University, Southport, Queensland, Australia.

Gold Coast Hospital and Health Service, Southport, Queensland, Australia.

出版信息

J Clin Nurs. 2019 Nov;28(21-22):4119-4127. doi: 10.1111/jocn.14967. Epub 2019 Aug 8.

Abstract

AIMS AND OBJECTIVE

To describe the prevalence and predictors of pressure injuries among older adults with limited mobility, within the first 36 hr of their hospital admission in Australia.

BACKGROUND

Pressure injuries are significant health, safety and quality of care issues for patients and healthcare organisations. The early implementation of the recommended pressure injury prevention international clinical practice guidelines is a way to reduce hospital-acquired pressure injuries. There is a paucity of evidence on the number of older persons who are admitted hospital with a pre-existing pressure injury.

DESIGN

Prospective correlational study conducted in eight tertiary referral hospitals across Australia. Our sample comprised of 1,047 participants aged ≥65 years with limited mobility, drawn from a larger Australian pragmatic cluster randomised trial.

METHODS

Using the STROBE statement, observational data were collected on participants' age, gender, presence of a pressure injury, Body Mass Index score, number of comorbidities and place of residence. These variables were analysed as potential predictors for pressure injuries within the first 36 hr of hospitalisation.

RESULTS

From our sample, 113/1047 (10.8%) participants were observed to have a pressure injury within the first 36 hr of hospital admission. Age, multiple comorbidities and living in an aged care facility predicted the prevalence of pressure injury among older people within the first 36 hr of hospitalisation.

CONCLUSIONS

Our findings confirm that older adults, those with multiple comorbidities and individuals living in aged care facilities are more likely to come to hospital with a pre-existing pressure injury or develop one soon after admission.

RELEVANCE TO CLINICAL PRACTICE

Many older patients come to hospital with a community-acquired pressure injury or develop a pressure injury soon after admission. This highlights the importance of the early detection of pressure injuries among older persons so that timely management strategies can be implemented along with the potential to reduce unnecessary financial penalties.

摘要

目的

描述澳大利亚老年人在入院 36 小时内,身体移动受限者中压疮的发生率及其预测因素。

背景

压疮是影响患者健康、安全和护理质量的重要问题,也是医疗保健机构面临的重要问题。尽早实施推荐的压疮预防国际临床实践指南,是减少医院获得性压疮的一种方法。关于有多少老年人入院时患有先前存在的压疮,目前证据很少。

设计

在澳大利亚的八所三级转诊医院进行前瞻性相关性研究。我们的样本包括 1047 名年龄≥65 岁、身体移动受限的参与者,他们来自澳大利亚一项大型实用聚类随机试验。

方法

使用 STROBE 声明,对参与者的年龄、性别、是否存在压疮、体重指数评分、合并症数量和居住地点等观察数据进行了收集。这些变量被分析为入院后 36 小时内发生压疮的潜在预测因素。

结果

在我们的样本中,有 113/1047(10.8%)名参与者在入院后 36 小时内观察到有压疮。年龄、多种合并症和在养老院居住预测了老年人在入院后 36 小时内发生压疮的可能性。

结论

我们的研究结果证实,老年人、患有多种合并症的人以及住在养老院的人更有可能在入院前患有社区获得性压疮或在入院后不久就患上压疮。

临床意义

许多老年患者在入院时患有社区获得性压疮,或在入院后不久就患上压疮。这凸显了早期发现老年人压疮的重要性,以便及时实施管理策略,同时有可能减少不必要的经济处罚。

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