成人不可分期压力性损伤患者伤口护理循证实践

Evidence-based practice of wound care in adults with unstageable pressure injury

目的将循证获取的成人不可分期压力性损伤患者伤口最佳证据应用到临床护理实践,以提高伤口治疗效果。方法成立循证实践小组,通过循证获取成人不可分期压力性损伤患者伤口护理最佳证据。选择2020年9月至2021年10月在某医院护理系统的压疮上报表单中登记的患者作为研究对象,随机分为试验组(n=112)和对照组(n=97),通过证据获取及培训进行最佳证据本土化改进,比较组间与组内护士压力性损伤分期及护理知识水平、对实践方案的执行率和患者压疮愈合情况。结果证据应用前后护理人员知识问卷得分明显提高(t=9.768,P<0.01),8条措施执行率较前明显改善,差异具有统计学意义(P<0.01或P<0.05),试验组压疮愈合评分表得分明显降低(t=7.977,P=0.001),且低于对照组(t=-5.989,P=0.001)。结论基于证据的成人不可分期压力性损伤伤口护理最佳实践方案,阐明了局部伤口治疗关键技术,有效促进了不可分期压力性损伤伤口的好转,方案接受度良好,同时提高了临床护士相关理论知识和实践技能。

Objective To explore the application of evidence-based best practice in promoting wound improvement in adult patients with unstageable pressure injury.Methods A evidence-based practice group was established to obtain the best wound care evidence for a⁃dult patients with unstageable pressure injury.Patients registered in the pressure injury reporting form of nursing system in a hospital from Sep⁃tember 2020 to October 2021 were selected as the research objects,and randomly divided into the experimental group(n=112)and the con⁃trol group(n=97).The best evidence localization improvement was carried out through evidence acquisition and training.The nurses'pressure injury stage and nursing knowledge level,the implementation rate of the practice plan and the healing status of patients'pressure injury were compared between the groups and within the group.Results Nursing staff knowledge questionnaire score improved significantly before and after evidence application(t=9.768,P<0.01),the implementation rate of 8 indexes was significantly improved(P<0.01 or P<0.05).The score scale of pressure ulcer healing in the experimental group decreased significantly(t=7.977,P=0.001),and was significantly lower than that of the control group(t=-5.989,P=0.001).Conclusion The evidence-based best practice plan of wound care for adult with unstage⁃able pressure injury constructed illustrates the key technology of local wound treatment,effectively promotes the improvement of wound care for unstageable pressure injury,is well accepted,and improves the relevant theoretical knowledge and practical skills of clinical nurses.