Lien Ru-Yu, Wang Chien-Ying, Hung Shih-Hsin, Lu Shu-Fen, Yang Wen-Ju, Chin Shu-I, Chiang Dung-Hung, Lin Hui-Chen, Cheng Chun-Gu, Cheng Chun-An
Department of Nursing, Taipei Veterans General Hospital, Taipei 112201, Taiwan.
School of Nursing, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan.
Healthcare (Basel). 2023 Jul 25;11(15):2116. doi: 10.3390/healthcare11152116.
(1) Background: Patients who are critically ill or undergo major surgery are admitted to intensive care units (ICUs). Prolonged immobilization is the most likely cause of pressure injuries (PrIs) in the ICU. Previous studies of Western populations found that effective protocols could reduce the incidence of PrIs, and the efficacy of systemic targeted intervention protocols in preventing PrIs in the Chinese population needs to be surveyed. (2) Methods: We reviewed cases of PrIs in the ICUs of Taipei Veterans General Hospital from 2014 to 2019. The ICU nurses at the hospital began to implement targeted interventions in January 2017. The incidence density of PrIs was calculated by dividing the number of PrIs by person days of hospitalizations in the pre-bundle (2014-2016) and post-bundle (2017-2019) stages. Poisson regression was performed to compare the trend of incidence densities. (3) Results: The incidence density of PrIs was 9.37/1000 person days during the pre-bundle stage and 1.85/1000 person days during the post-bundle stage ( < 0.001). The relative risk (RR) was 0.197 (95% confidence interval: 0.149-0.26). The incidence densities of iatrogenic PrIs and non-iatrogenic PrIs decreased as the RRs decreased. (4) Conclusions: Targeted interventions could significantly reduce the incidence of PrIs. Healthcare providers must follow the bundle care protocol for PrI prevention to improve the quality of healthcare and promote patient health.
（1）背景：危重症患者或接受大手术的患者会被收治入重症监护病房（ICU）。长期制动是ICU中发生压力性损伤（PrI）的最可能原因。先前针对西方人群的研究发现，有效的方案可降低PrI的发生率，而系统性靶向干预方案在中国人群中预防PrI的效果有待调查。（2）方法：我们回顾了台北荣民总医院ICU在2014年至2019年期间的PrI病例。该医院的ICU护士于2017年1月开始实施靶向干预。通过将PrI的数量除以前束阶段（2014 - 2016年）和后束阶段（2017 - 2019年）的住院人日数来计算PrI的发病密度。进行泊松回归以比较发病密度的趋势。（3）结果：前束阶段PrI的发病密度为9.37/1000人日，后束阶段为1.85/1000人日（<0.001）。相对风险（RR）为0.197（95%置信区间：0.149 - 0.26）。医源性PrI和非医源性PrI的发病密度随着RR的降低而下降。（4）结论：靶向干预可显著降低PrI的发生率。医疗服务提供者必须遵循预防PrI的集束护理方案，以提高医疗质量并促进患者健康。
