School of Nursing, University of Michigan, Ann Arbor, MI, USA.
J Clin Nurs. 2020 Apr;29(7-8):1398-1421. doi: 10.1111/jocn.15171. Epub 2020 Jan 20.
Despite decades of research, pressure injuries continue to be a source of significant pain and delayed recovery for patients and substantial quality and cost issues for hospitals. Consideration of the current thinking around pressure injury risk must be evaluated to improve risk assessments and subsequent nursing interventions aimed at reducing hospital-acquired pressure injuries.
This is a discursive paper using Walker and Avant's (2005) theory synthesis framework to examine the relevance of existing pressure injury models as they align with the current literature.
PubMed and CINAHL indexes were searched, first for conceptual models and then for pressure injury research conducted on hospitalised patients for the years 2006-2016. A synthesis of the searches culminated into a new pressure injury risk model.
Gaps in previous models include lack of attention to the environment, contributing episode-of-care factors and the dynamic nature of injury risk for patients. Through theory synthesis, the need for a new model representing the full risk for pressure injury was identified. The Pressure Injury Predictive Model is a representation of the complex and dynamic nature of pressure injury risk that builds on previous models and addresses new patient, contextual and episode-of-care process influences. The Pressure Injury Predictive Model (PIPM) provides a more accurate picture of the complexity of contextual and process factors associated with pressure injury development.
Using the PIPM to determine risk can result in improved risk identification. This information can be used to implement targeted, evidence-based pressure injury prevention interventions specific to the patient risk profile, thus limiting unwarranted and unnecessary care.
尽管经过了几十年的研究，压力性损伤仍然是患者疼痛和康复延迟的主要原因，也是医院质量和成本的重大问题。必须考虑当前对压力性损伤风险的思考，以改善风险评估和随后旨在减少医院获得性压力性损伤的护理干预措施。
这是一篇论述性论文，使用 Walker 和 Avant（2005）的理论综合框架来检查现有压力性损伤模型与当前文献的相关性。
首先在 PubMed 和 CINAHL 索引中搜索概念模型，然后在 2006-2016 年期间针对住院患者的压力性损伤研究进行搜索。搜索的综合结果产生了一个新的压力性损伤风险模型。
先前模型中的差距包括对环境、促成医疗护理事件因素以及患者损伤风险的动态性质的关注不足。通过理论综合，确定了需要一个新的模型来代表压力性损伤的全部风险。压力性损伤预测模型是对压力性损伤风险的复杂和动态性质的表示，它建立在先前的模型基础上，并考虑了新的患者、背景和医疗护理事件过程的影响。压力性损伤预测模型（PIPM）更准确地描绘了与压力性损伤发展相关的背景和过程因素的复杂性。
使用 PIPM 确定风险可以提高风险识别的准确性。这些信息可以用于针对患者风险概况实施有针对性的、基于证据的压力性损伤预防干预措施，从而限制不必要和不必要的护理。
