压力性溃疡：医院环境下的监测挑战。
Pressure ulcers: The challenge of monitoring in hospital context.
机构信息
University of Lisbon, Faculty of Human Kinetics, Aventura Social, Lisbon, Portugal; University of Lisbon, Faculty of Medicine, Environmental Health Institute (ISAMB), Lisbon, Portugal.
University of Lincoln, Lincolnshire, United Kingdom; University of Hertfordshire, School of Life and Medical Sciences, Hertforshire, United Kingdom.
出版信息
Appl Nurs Res. 2020 Jun;53:151266. doi: 10.1016/j.apnr.2020.151266. Epub 2020 Apr 11.
AIM
To describe and analyse the PUs problem based on data from hospital electronic health records.
METHODS
A retrospective cohort descriptive study was performed based on electronic health records (medical and nursing) from adult patients (≥18 years) admitted to medical, surgical and orthopaedics wards during 2016 after implementation of National Strategy of Patient Safety 2015-2020. Ethical approval was obtained.
RESULTS
A sample of 3904 patients was obtained, 66% (n = 2575) were older than 65 years, 24.6% (n = 962) at admission and 21.2% (n = 829) at discharge stay at high risk of develop PUs and 88.6% (n = 3458) has no visual skin assessment. PUs identification, categorization and localization are inconsistent between nurses and doctors.
CONCLUSION
The creation of a unified minimum dataset for PUs monitoring to standardize data on the occurrence of PUs and assessed the effectiveness of preventive strategies in patient at risk of PUs development at national level is need. Current Portuguese guideline of PUs needs a review and an innovating upgrade with zero tolerance for PUs.
目的
基于医院电子病历数据描述和分析压力性溃疡（PU）问题。
方法
这是一项回顾性队列描述性研究，基于 2015-2020 年国家患者安全战略实施后，2016 年入住内科、外科和骨科病房的成年患者（≥18 岁）的电子健康记录（医疗和护理）。本研究获得了伦理批准。
结果
获得了 3904 例患者的样本，66%（n=2575）的患者年龄大于 65 岁，24.6%（n=962）在入院时和 21.2%（n=829）在出院时处于发生压力性溃疡的高风险中，88.6%（n=3458）的患者没有进行可视化皮肤评估。护士和医生之间在压力性溃疡的识别、分类和定位方面存在不一致。
结论
需要创建一个统一的压力性溃疡监测最小数据集，以规范压力性溃疡发生的数据，并评估在国家层面有压力性溃疡发展风险的患者的预防策略的有效性。目前葡萄牙的压力性溃疡指南需要进行审查和创新升级，对压力性溃疡采取零容忍态度。
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