高龄Ⅲ期压疮患者一例的循证护理

Evidence-based Nursing of Stage Ⅲ Pressure Ulcers Old Patient

目的为l例高龄Ⅲ期压疮患者确定基于循证的压疮护理方案。方法按照PICO原则,针对患者的临床表现提出护理问题,计算机检索Cochrane图书馆(2012)、PubMed(1980-2012)、EMBASE(1974-2012)、JBI循证数据库(2012)及中国生物医学文献数据库(1978-2012),共纳入2篇临床指南、7篇系统评价及证据总结,结合患者情况,从压疮伤口消毒、床具、营养支持、换药敷料等方面实施针对性护理。结果 3d后,患者左足跟外侧结痂脱落;15d后,尾骶部压疮痊愈,长出新生皮肤,色泽鲜红,无渗液,无异味。结论采用循证的方法可以为患者提供更加科学和个性化的护理方案,有效治疗和预防压疮,减轻患者的痛苦,提高护理质量。

Objective To formulate an evidence-based nursing for an old patient with stage III pressure ulcer. Methods Based on the patient＇s clinical presentation and the principle of PICO,we searched the Co- chrane Library （2012） ,PubMed （1980.1 to 2012.12） ,EMBASE （1974 to 2012） ,JBI evidence-based data- base （2012.12.5） and CBM （1978 to 2012） to collect 2 clinical guidelines and 7 systematic reviews and evi- dence summaries. Combined with the condition of patients, the target nursing of pressure ulcers was imple- mented from the aspect of wound disinfection, bedding, nutritional support and dressings. Results Three days later,the crusts on the lateral side of left foot fell off. And after 15 days,the pressure sores in sacro- coccygeal region healed,with bright red new skin growing, no oozing and no peculiar smell. Conclusion Application of the evidence-based method can not only provide patients with a more scientific and personal- ized nursing plan, effective treatment and prevention of pressure ulcers, but also relieve the suffering of the patients, and eventually improve the quality of nursing.