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成人危重症患者压力性损伤预防:最佳实践实施项目。

Pressure injury prevention in adult critically ill patients: best practice implementation project.

机构信息

Sociedade Beneficente de Senhoras Hospital Sírio-Libanês.

School of Nursing, University of São Paulo (EEUSP).

出版信息

JBI Evid Implement. 2023 Sep 1;21(3):218-228. doi: 10.1097/XEB.0000000000000352.

Abstract

OBJECTIVE

This study assessed compliance with the best practices for pressure injury prevention among ICU patients at a tertiary hospital in São Paulo, Brazil.

INTRODUCTION

Intensive care patients are at high risk of developing a pressure injury; preventing this requires a best practice protocol.

METHOD

This best practice implementation project was conducted in a Brazilian tertiary hospital in three phases following the JBI Model of Evidence-based Healthcare. Ten criteria derived from the best available evidence were audited and monitored before and after best practice implementation.

RESULTS

The baseline and follow-up audits evaluated 28 patients at each step. A total of 448 h of care were analyzed using a monitoring camera and medical records. Compliance with all 10 audited criteria increased, with a 50% reduction in the prevalence of pressure injuries in intensive care. Of the 223 employees, 71% claimed to have some knowledge of pressure injury prevention, and 66% reported adequate adherence to prevention protocols.

CONCLUSION

The audit and feedback strategy improved compliance with the criteria. Future audits are needed to promote the sustainability of evidence-based practice.

摘要

目的

本研究评估了巴西圣保罗一家三级医院 ICU 患者预防压力性损伤的最佳实践的依从性。

简介

重症监护患者发生压力性损伤的风险很高;预防这需要一个最佳实践方案。

方法

本最佳实践实施项目按照 JBI 循证医疗模式分三个阶段在巴西一家三级医院进行。在实施最佳实践之前和之后,审核和监测了来自最佳可用证据的 10 个标准。

结果

基线和随访审核在每个步骤分别评估了 28 名患者。使用监测摄像机和病历分析了总共 448 小时的护理。所有 10 项审核标准的依从性均有所提高,重症监护中压力性损伤的发生率降低了 50%。在 223 名员工中,71%的人声称对预防压力性损伤有一定的了解,66%的人报告说预防方案的依从性良好。

结论

审核和反馈策略提高了对标准的依从性。需要进行未来的审核,以促进循证实践的可持续性。

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