Suntken G, Starr B, Ermer-Seltun J, Hopkins L, Preftakes D
Ostomy Wound Manage. 1996 Mar;42(2):20-2, 24-6, 28-30 passim.
Healthcare professionals in the Central Midwest identified the need for a comprehensive skin care program for pressure ulcer prevention and treatment across care settings. A multidisciplinary team, representing acute, extended and home care, was formed to create a program for all three settings based upon the AHCPR pressure ulcer guidelines. The team performed literature reviews on which to base the development and use of tools, conducted prevalence studies, and developed educational approaches. Implementation of the program was tailored for each setting. Some of the approaches used were a skin care fair, quality studies, continuous quality improvement concepts, a "Product Book" and educational presentations. Outcomes include improvement of continuity of care across settings and the use of the Braden Scale and the NPUAP pressure ulcer staging system. The focus has turned toward patient outcomes. Professionals have a better understanding of the care that is provided by other disciplines. Referrals are made based upon decision trees. Appropriate resources are used. Other outcomes anticipated include a decrease in nosocomial pressure ulcers, shortened wound healing time, appropriate referral of unresponsive chronic wounds, decreased discrepancies in wound documentation, decreased length of stay, improved financial outcomes, and improved client knowledge and participation.
中西部中心地区的医疗保健专业人员认识到，需要制定一项全面的皮肤护理计划，以在各种护理环境中预防和治疗压疮。一个由急性护理、长期护理和家庭护理代表组成的多学科团队，根据AHCPR压疮指南，为所有这三种护理环境制定了一个计划。该团队进行了文献综述，以此为基础开发和使用工具、开展患病率研究并制定教育方法。该计划的实施针对每种护理环境进行了调整。所采用的一些方法包括皮肤护理博览会、质量研究、持续质量改进概念、一本“产品手册”以及教育讲座。成果包括改善不同护理环境之间的护理连续性，以及使用Braden量表和NPUAP压疮分期系统。重点已转向患者的治疗效果。专业人员对其他学科提供的护理有了更好的理解。转诊是根据决策树进行的。使用了适当的资源。预期的其他成果包括减少医院获得性压疮、缩短伤口愈合时间、对无反应的慢性伤口进行适当转诊、减少伤口记录中的差异、缩短住院时间、改善财务状况以及提高患者的知识水平和参与度。
