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医疗器械相关压力性损伤护理与预防培训项目(DevICeU):对重症监护护士知识、预防措施执行情况及现患率的影响

Medical Device-Related Pressure Injury Care and Prevention Training Program (DevICeU): Effects on intensive care nurses' knowledge, prevention performance and point prevalence.

作者信息

Erbay Dallı Öznur, Kelebek Girgin Nermin

机构信息

Bursa Uludag University Faculty of Health Sciences, Department of Internal Medicine Nursing, Nilüfer, BURSA 16059, Turkey.

Bursa City Hospital, Department of Anesthesiology and Reanimation, Division of Intensive Care, Nilüfer, BURSA 16110, Turkey.

出版信息

Intensive Crit Care Nurs. 2024 Jun;82:103622. doi: 10.1016/j.iccn.2024.103622. Epub 2024 Jan 11.

Abstract

OBJECTIVE

To determine the effect of the training given to intensive care unit (ICU) nurses to prevent medical device-related pressure injuries (MDRPIs) on nurses' knowledge levels, their prevention performance, and the point prevalence (PP) of MDRPIs.

RESEARCH METHODOLOGY/DESIGN: A pre-post test intervention study without a control group.

SETTING

The study was conducted between May and July 2023 with ICU nurses in three phases: pre-training phase (E0) (104 nurses, 116 patients), training implementation phase (E) and post-training phase (E1) (89 nurses, 120 patients).

MAIN OUTCOME MEASURES

The data were collected by using the Patient (E0, E1) and Nurse (E0) Characteristic Forms, MDRPI Follow-up and Prevalence Form (E0, E1), D.E.V.I.C.E Performance Observation Checklist (E0, E1), MDRPI Knowledge Assessment Questionnaire (E0, E1), Braden Pressure Ulcer Risk Assessment Scale (E0, E1), Pressure Injury Grading Form (E0, E1), and Feedback Form about the Training Process (E).

RESULTS

The mean MDRPI knowledge score of the nurses increased significantly from E0 to E1 (13.23 ± 1.43 vs. 20.02 ± 1.30, p = 0.001), with the highest improvement in the staging and prevention themes. Nurses' MDRPI prevention performance increased significantly from E0 to E1 (2.15 ± 1.01 vs. 11.17 ± 1.65, p = 0.001). There was a significant difference between the PP rate at E0 (61.2 %) and E1 (27.5 %) (p = 0.001).

CONCLUSION

The study indicated that the training on MDRPIs given to ICU nurses increased their knowledge and prevention performance and decreased the prevalence of MDRPIs. However, further studies with a larger sample size are needed to confirm these findings.

IMPLICATIONS FOR CLINICAL PRACTICE

Since MDRPIs have more complex staging and prevention practices than conventional PIs, they require the adoption of a training approach that includes visual materials and practical methods in addition to theoretical knowledge. Accurate definitions of medical device dimensions and fixation, skin assessment, and prevention practices will lead to the desired outcome of reducing MDRPIs in ICUs.

摘要

目的

确定对重症监护病房(ICU)护士进行预防与医疗设备相关压力性损伤(MDRPI)培训对护士知识水平、预防措施执行情况以及MDRPI现患率(PP)的影响。

研究方法/设计:一项无对照组的前后测干预研究。

研究背景

该研究于2023年5月至7月对ICU护士分三个阶段开展:培训前阶段(E0)(104名护士,116名患者)、培训实施阶段(E)和培训后阶段(E1)(89名护士,120名患者)。

主要观察指标

通过使用患者(E0、E1)和护士(E0)特征表、MDRPI随访及现患率表(E0、E1)、D.E.V.I.C.E性能观察检查表(E0、E1)、MDRPI知识评估问卷(E0、E1)、Braden压疮风险评估量表(E0、E1)、压力性损伤分级表(E0、E1)以及培训过程反馈表(E)收集数据。

结果

护士的MDRPI知识平均得分从E0到E1显著提高(13.23±1.43对20.02±1.30,p = 0.00),其中分期和预防主题的提高最为显著。护士的MDRPI预防措施执行情况从E0到E1显著改善(2.15±1.01对11.17±1.65, p = 0.001)。E0(61.2%)和E1(27.5%)的PP率之间存在显著差异(p = 0.001)。

结论

该研究表明,对ICU护士进行的MDRPI培训提高了他们的知识水平和预防措施执行情况,并降低了MDRPI的患病率。然而,需要进一步开展更大样本量的研究来证实这些结果。

对临床实践的启示

由于MDRPI的分期和预防措施比传统压力性损伤更为复杂,除理论知识外,还需要采用包括视觉材料和实践方法在内的培训方法。准确界定医疗设备尺寸和固定方式、皮肤评估以及预防措施将有助于在ICU中实现降低MDRPI的预期效果。

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