Departments of Trauma Services (Dr Serrano), Surgery (Dr Wong), and Emergency Medicine (Dr Neeki), Arrowhead Regional Medical Center, Colton, California; St. George's University, Great River, New York (Mr Paiva); and College of Graduate Medical Science, Western University of Health Sciences, Pomona, California (Dr Dong).
J Trauma Nurs. 2020 Jul/Aug;27(4):246-249. doi: 10.1097/JTN.0000000000000521.
Hospital-acquired pressure injuries are a chronic phenomenon in health care, and their prevention is an ongoing challenge. This study aims to investigate whether the application of a silicone-bordered multilayered foam dressing during the initial trauma resuscitation reduces sacral hospital-acquired pressure injury occurrence in trauma patients.
This is a single-center quality improvement study using a nonequivalent control group posttest-only design to study the effect of silicone-bordered multilayered foam dressing on the incidence of hospital-acquired pressure injuries. The study population included admitted, highest tier trauma activations, age 18 years and older. Preimplementation 2014 data were compared with postimplementation 2018 data.
The result showed no statistically significant reduction in hospital-acquired pressure injury occurrence between the control and intervention groups. Incident rates for sacral hospital-acquired pressure injuries were 0.23% (2014) compared with 0.21% (2018). No statistically significant difference was found in the hospital and intensive care lengths of stay or injury severity. Preventive dressing costs were $7,689 annually compared with the estimated treatment costs of $70,000 per hospital-acquired pressure injury.
Although this study's hospital-acquired pressure injury reduction rate was not significant, the inclusion of multidisciplinary team members in the quality improvement project led to the cultural hardwiring of hospital-acquired pressure injury prevention among all team members beyond that of just nursing.
医院获得性压疮是医疗保健中的一种慢性现象，其预防是一个持续存在的挑战。本研究旨在探讨在初始创伤复苏期间应用硅胶边框多层泡沫敷料是否会降低创伤患者发生骶部医院获得性压疮的发生率。
这是一项使用非等效对照组后测试仅设计的单中心质量改进研究，旨在研究硅胶边框多层泡沫敷料对医院获得性压疮发生率的影响。研究人群包括入住、最高层级创伤激活、年龄 18 岁及以上的患者。比较 2014 年实施前的数据与 2018 年实施后的数据。
结果显示，对照组和干预组之间医院获得性压疮发生率无统计学显著降低。骶部医院获得性压疮的发生率分别为 0.23%（2014 年）和 0.21%（2018 年）。在医院和重症监护病房的住院时间或损伤严重程度方面无统计学显著差异。预防性敷料费用每年为 7689 美元，而每例医院获得性压疮的估计治疗费用为 7 万美元。
尽管本研究的医院获得性压疮降低率不显著，但多学科团队成员参与质量改进项目导致了医院获得性压疮预防在所有团队成员中的文化强化，不仅仅是护理人员。
