Regan M B, Byers P H, Mayrovitz H N
Adv Wound Care. 1995 May-Jun;8(3):49, 51-2, 54-5.
The effects of a comprehensive pressure ulcer prevention program on the incidence of nosocomial skin breakdown and cost effectiveness were evaluated in this 8-month prospective study and follow-up after an 11-month interval. Baseline data were collected on all residents of a 125-bed nursing home who were present at the study start or were subsequently admitted during the initial 8-month interval. Reassessments were conducted on all residents at 2-month intervals during the initial 8-month study period. New admissions were similarly assessed. The program, which was modeled in accordance with the AHCPR's guideline on pressure ulcers, was implemented after staff education and a 2-month evaluation of residents. A total of 241 residents were entered in the study, the majority of whom were female, incontinent, and at high risk for pressure ulcers. After program implementation, the incidence of pressure ulcers decreased significantly (p < .001) at each of the four initial post-program measurement periods and the 11-month follow-up. The cost analysis for the 8-month study period revealed savings that totalled more than $230,000 for the prevention program versus treatment costs. Findings support the implementation of comprehensive pressure ulcer prevention programs in extended care facilities to decrease the dollar cost of care and the cost of human suffering with a pressure ulcer.
在这项为期8个月的前瞻性研究以及间隔11个月后的随访中，评估了一项全面的压疮预防计划对医院获得性皮肤破损发生率和成本效益的影响。收集了一家拥有125张床位的养老院所有居民的基线数据，这些居民在研究开始时就已入住，或在最初的8个月期间随后入院。在最初的8个月研究期间，每隔2个月对所有居民进行重新评估。对新入院患者也进行了类似评估。该计划是根据AHCPR关于压疮的指南制定的，在对工作人员进行教育和对居民进行2个月评估后实施。共有241名居民参与了这项研究，其中大多数是女性，大小便失禁，且有发生压疮的高风险。在实施该计划后，在最初的四个计划后测量期以及11个月的随访中，压疮的发生率均显著下降（p < 0.001）。对8个月研究期的成本分析显示，与治疗成本相比，预防计划总共节省了超过23万美元。研究结果支持在长期护理机构实施全面的压疮预防计划，以降低护理成本以及压疮给患者带来的痛苦成本。
