Stotts N A, Deosaransingh K, Roll F J, Newman J
Department of Physiological Nursing, University of California, San Francisco, USA.
Adv Wound Care. 1998 Jan-Feb;11(1):32-8.
Patients with hip fractures are at high risk for pressure ulcer development, yet few recent studies have addressed risk assessment in this population. In this retrospective medical record survey, records of a random sample of California Medicare beneficiaries with hip fractures admitted to acute care hospitals in 1995 were selected for abstraction. Medical record abstraction (n = 545) revealed that risk assessment was performed on only 44.2% (241/545) of patients. Among these, 64.3% were identified as at risk for pressure ulcer development. Accuracy of the risk assessment was evaluated independently and compared with those performed by the nursing staff; there was agreement in only 40% of cases. Ulcers developed in 19.1% of the sample, and pressure ulcer development was not related to risk status at hospital admission. Patients with longer hospital stays developed more ulcers than those discharged earlier. This study shows that risk assessment is underutilized, inaccurate, and unrelated to pressure ulcer development in hip fracture patients.
髋部骨折患者发生压疮的风险很高，但近期很少有研究涉及该人群的风险评估。在这项回顾性病历调查中，选取了1995年入住加利福尼亚州急性护理医院的髋部骨折医疗保险受益人的随机样本记录进行摘要分析。病历摘要分析（n = 545）显示，仅对44.2%（241/545）的患者进行了风险评估。其中，64.3%的患者被确定有发生压疮的风险。对风险评估的准确性进行了独立评估，并与护理人员进行的评估结果进行了比较；仅40%的病例评估结果一致。样本中有19.1%的患者发生了溃疡，且压疮的发生与入院时的风险状况无关。住院时间较长的患者比早出院的患者发生更多溃疡。这项研究表明，髋部骨折患者的风险评估未得到充分利用、不准确，且与压疮的发生无关。
