重症监护环境中的压力性损伤发生率：一项观察性前后干预研究。
Pressure injury prevalence in critical care settings: An observational pre-post intervention study.
机构信息
School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, NSW, Australia.
Taibah University, Madinah, Saudi Arabia.
出版信息
Nurs Open. 2024 Feb;11(2):e2110. doi: 10.1002/nop2.2110.
AIM
To explore pressure injury prevention practices and evaluate the impact of an educational intervention on PI prevalence before and after an educational intervention.
DESIGN
A multi-centre observational study.
METHOD
Data were collected at two time points in May 2021 and April 2022 using a Qualtrics® online form. Two Registered Nurses at each site collected observational data at each time point by diagnosing and staging any identified pressure injuries as part of a prevalence study. Patients admitted to participating units were included.
RESULTS
A total of 181 patients in critical care units were included at the two-time points. Pressure injury prevalence was 60.9% at the outset, with 52.9% hospital-acquired, 37.9% unit-acquired and 23.0% medical device-related. Post-intervention prevalence decreased significantly to 28.7%, including 21.3% hospital-acquired, 14.9% unit-acquired, and 8.5% medical device-related. Pressure injuries were prominent in the sacral region, head area, and heels. Stages I and II pressure injuries were the most common. Increased age and longer ICU stays are linked to a heightened risk of pressure injury development in critically ill patients, whereas higher haemoglobin levels show an inverse relationship with the development of both pressure injury and severe stages in the univariate analysis. The predictive models revealed that increased age and longer ICU stays are predictors for both pressure injury development and progression to severe stages, while Braden scores predict the likelihood of developing severe stages of pressure injuries.
CONCLUSIONS
This study has identified a benchmark for pressure injury prevalence in critical care units in Saudi Arabia. The results demonstrate that pressure injuries can be prevented in critically ill patients when evidence-based education strategies are implemented.
PATIENT CARE IMPACT
Pressure injuries are an important issue for critically ill patients and can be prevented with proper investments. Strategies to prevent pressure injuries from admission will result in fewer pressure injuries.
REPORTING METHOD
Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines and the Template for Intervention Description and Replication (TIDieR) checklist.
PATIENT OR PUBLIC CONTRIBUTION
No patient or public contribution.
目的
探讨压力性损伤预防措施，并评估教育干预前后压力性损伤发生率的变化。
设计
多中心观察性研究。
方法
于 2021 年 5 月和 2022 年 4 月使用 Qualtrics®在线表格分两个时间点收集数据。每个地点的两名注册护士在每个时间点通过诊断和分期任何已识别的压力性损伤来收集观察数据，作为患病率研究的一部分。纳入入住参与单位的患者。
结果
在两个时间点共纳入 181 例重症监护病房患者。压力性损伤发生率为 60.9%，其中 52.9%为医院获得性，37.9%为单元获得性，23.0%与医疗器械相关。干预后发生率显著下降至 28.7%，其中 21.3%为医院获得性，14.9%为单元获得性，8.5%与医疗器械相关。压力性损伤多见于骶尾部、头部和足跟。I 期和 II 期压力性损伤最为常见。年龄增长和 ICU 住院时间延长与重症患者压力性损伤发展风险增加相关，而血红蛋白水平升高与压力性损伤和严重分期的发生呈负相关。单因素分析显示，预测模型表明年龄增长和 ICU 住院时间延长是压力性损伤发展和进展为严重分期的预测因素，而Braden 评分预测严重分期压力性损伤发生的可能性。
结论
本研究确定了沙特阿拉伯重症监护病房压力性损伤发生率的基准。结果表明，当实施基于证据的教育策略时，可预防重症患者发生压力性损伤。
患者护理影响
压力性损伤是重症患者的一个重要问题，适当的投资可以预防。从入院开始预防压力性损伤的策略将减少压力性损伤的发生。
报告方法
采用观察性研究的强化报告（STROBE）指南和干预描述与复制（TIDieR）清单。
患者或公众贡献
无患者或公众贡献。
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