使用公共医疗机构在线系统监测卧床老年患者的压疮信息及登记（SIRUPP）：一项医疗保健影响研究的方案

Monitoring Immobilized Elderly Patients Using a Public Provider Online System for Pressure Ulcer Information and Registration (SIRUPP): Protocol for a Health Care Impact Study.

作者信息

Vera-Salmerón Eugenio, Rutherford Claudia, Dominguez-Nogueira Carmen, Tudela-Vázquez María Pilar, Costela-Ruiz Victor J, Gómez-Pozo Basilio

机构信息

Distrito Sanitario Granada-Metropolitano (Servicio Andaluz de Salud), Armilla, Spain.

Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain.

出版信息

JMIR Res Protoc. 2019 Aug 12;8(8):e13701. doi: 10.2196/13701.

DOI:10.2196/13701

PMID:31407669

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6709896/

Abstract

BACKGROUND

Pressure ulcers represent a major challenge to patient safety in the health care context, presenting high incidence (from 7% to 14% in Spain) and increased financial costs (€400-600 million/year) in medical treatment. Moreover, they are a significant predictor of mortality. The prevention of pressure ulcers in long-term care centers and patients' own homes is proposed as a priority indicator of health care quality. Early stage risk assessment and database recording are both crucial aspects of prevention, classification, diagnosis, and treatment.

OBJECTIVE

This project proposes a 3-year study of immobilized patients residing in the Granada-Metropolitan Primary Healthcare District (DSGM) and monitored via the Pressure Ulcer Information and Registration System (SIRUPP, Spanish initials). The project aims to estimate the incidence of PUs among immobilized elderly patients, analyze the health-related quality of life of these patients by using the Pressure Ulcer Quality of Life (PU-QoL) instrument in a sample of 250 patients, determine the average time to complete wound healing, estimate the rate of pressure ulcers-associated mortality, and assess the predictive value of the Braden and Mini Nutritional Assessment risk measurement scales in a sample of 1700 patients.

METHODS

The DSGM runs SIRUPP, which is linked to patients' electronic health records. Currently, 17,104 immobilized patients are monitored under this system. Health-related quality of life will be measured by patient self-reports using the Spanish Pressure Ulcer Quality of Life questionnaire, following cross-cultural adaptation and psychometric validation with respect to the English-language version.

RESULTS

The project commenced in June 2017 and is expected to conclude in April 2020.

CONCLUSIONS

This study addresses two main health outcomes-the time needed for wound healing and the mortality associated with pressure ulcers-both of which might be accounted for by variations in clinical practice and the health-related quality of life of patients with pressure ulcers.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/13701.

摘要

背景

在医疗环境中，压疮对患者安全构成重大挑战，发病率较高（西班牙为7%至14%），且医疗费用增加（每年4亿至6亿欧元）。此外，压疮还是死亡率的重要预测指标。在长期护理中心和患者家中预防压疮被视为医疗质量的优先指标。早期风险评估和数据库记录是预防、分类、诊断和治疗的关键环节。

目的

本项目提议对居住在格拉纳达-大都会初级医疗保健区（DSGM）并通过压疮信息与登记系统（SIRUPP，西班牙语首字母缩写）进行监测的卧床患者开展为期3年的研究。该项目旨在估计卧床老年患者中压疮的发病率，通过对250名患者样本使用压疮生活质量（PU-QoL）工具分析这些患者的健康相关生活质量，确定伤口愈合的平均时间，估计压疮相关死亡率，并评估Braden和简易营养评估风险测量量表在1700名患者样本中的预测价值。