Goldrick B A, Larson E L
Center for Nursing Research, Georgetown University School of Nursing, Washington, DC 20007.
J Community Health Nurs. 1993;10(1):23-9. doi: 10.1207/s15327655jchn1001_3.
The purpose of this study was to determine the status of wound care management among home health agencies (HHAs) in the U.S. The survey was mailed to 562 randomly selected HHAs within all 10 HCFA regions. Two hundred and ninety-six agencies (53%) responded to the survey. The majority (56%) of the respondents did not have written policies and procedures specific to wound management. The investigators were able to analyze the documents of those who had indicated that they had written policies and sent copies of them (n = 87, 67%). The majority (76%) of these had separate wound assessment protocols, but only 14% had separate preventive skin assessment protocols. Sixty-four percent had treatment protocols for more than one type of wound, while the remaining 46% used no specific treatment protocol or used treatments based on physicians' orders only. Most of the HHAs with written wound management policies required documentation of wound status; however, only half had patient/caregiver teaching as part of the policy. Although there is a need for clinically useful, well-tested, standardized approaches to wound care, the results of this study indicated that there is inconsistency regarding wound care management among HHAs within the U.S.
本研究的目的是确定美国家庭健康机构（HHA）中伤口护理管理的现状。该调查被邮寄给10个医疗保健财务管理局（HCFA）区域内随机选择的562家HHA。296家机构（53%）回复了调查。大多数（56%）受访者没有针对伤口管理的书面政策和程序。研究人员能够分析那些表示有书面政策并发送了副本的机构的文件（n = 87，67%）。其中大多数（76%）有单独的伤口评估方案，但只有14%有单独的预防性皮肤评估方案。64%的机构有针对不止一种伤口类型的治疗方案，而其余46%没有使用特定的治疗方案或仅根据医生的医嘱进行治疗。大多数有书面伤口管理政策的HHA要求记录伤口状况；然而，只有一半将患者/护理人员教育作为政策的一部分。尽管需要临床上有用的、经过充分测试的标准化伤口护理方法，但这项研究的结果表明，美国国内HHA之间在伤口护理管理方面存在不一致性。
