一种降低骶骨部医院获得性压力性损伤的跨学科团队方法：一项回顾性队列研究。

An Interdisciplinary Team Approach to Decrease Sacral Hospital-acquired Pressure Injuries: A Retrospective Cohort Study.

作者信息

Isaacs Shelby, Pinhasov Tamir, Oropallo Alisha, Brennan Mary, Rao Amit, Landis Gregg, Agrell-Kann Marie, Li Timmy

机构信息

Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York.

Department of Surgery, Comprehensive Wound Care Healing and Hyperbarics, Northwell Health, Lake Success, New York; Department of Vascular Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York.

出版信息

Wound Manag Prev. 2021 May;67(5):26-32.

PMID:34283802

Abstract

BACKGROUND

Hospital-acquired pressure injuries (HAPIs) of the sacrum are among the most common iatrogenic events in health care. Multi-intervention programs have been shown to decrease the prevalence of pressure injuries.

PURPOSE

To assess changes in the yearly incidence of sacral HAPIs before and after implementation of a 3-pronged interdisciplinary intervention to reduce HAPI incidence.

METHODS

A retrospective study of all patients admitted between 2010 and 2017 was conducted to evaluate the effect of a 2012 initiative on the incidence of sacral HAPIs. In 2012, an interdisciplinary team was created, and enhanced education programs for nursing staff and quality data reporting measures were implemented for all patients admitted to North Shore University Hospital, Manhasset, NY. Pre- and post-intervention patient variables and sacral HAPI outcomes were compared.

RESULTS

Pre- intervention, the sacral HAPI incidence was 0.353% and 0.267% (mean 0.31%) in the years 2010 and 2011, respectively. Post-intervention the HAPI incidence was 0.033%, 0.043%, 0.008%, 0.007%, and 0.004% in the years 2013, 2014, 2015, 2016, and 2017, respectively (mean 0.019%) (2-sample unpaired t-statistic: 11.5937; P < .001). Significant variables and outcomes differences between pre-intervention (n = 245) and post-intervention (n = 49) patients with a sacral HAPI were seen for race (P < .0001), length of stay (P = .0096), and HAPI stage (P < .0001).

CONCLUSION

A hospital-wide, multi-part, interdisciplinary intervention resulted in a significant and sustained reduction in the incidence of sacral HAPIs.

摘要

背景

骶骨部位的医院获得性压力性损伤（HAPI）是医疗保健中最常见的医源性事件之一。多项干预计划已被证明可降低压力性损伤的患病率。

目的

评估实施一项三管齐下的跨学科干预措施以降低HAPI发病率前后，骶骨HAPI年发病率的变化。

方法

对2010年至2017年期间收治的所有患者进行回顾性研究，以评估2012年一项举措对骶骨HAPI发病率的影响。2012年，组建了一个跨学科团队，并为纽约州曼哈塞特北岸大学医院收治的所有患者实施了针对护理人员的强化教育计划和质量数据报告措施。比较干预前后患者的变量和骶骨HAPI结果。

结果

干预前，2010年和2011年骶骨HAPI发病率分别为0.353%和0.267%（平均0.31%）。干预后，2013年、2014年、2015年、2016年和2017年的HAPI发病率分别为0.033%、0.043%、0.008%、0.007%和0.004%（平均0.019%）（双样本非配对t统计量：11.5937；P <.001）。在发生骶骨HAPI的干预前患者（n = 245）和干预后患者（n = 49）之间，在种族（P <.0001）、住院时间（P =.0096）和HAPI分期（P <.0001）方面观察到显著的变量和结果差异。