69例住院病人院内获得性压疮原因及对策

Hospital-acquired pressure ulcer:Cause analysis and preventive measure in 69 inpatients

目的：分析医院获得性压疮发生的原因和特点，并探讨其对策。方法：回顾分析某三级甲等综合性医院2012～2013年上报的69例院内发生压疮事件，对压疮发生的年龄、部位、科室、分级、预后及发生原因进行分析。结果：医院获得性压疮发生率排序前三位年龄范围分别为89岁以上、80～89岁及70～79岁；前三位压疮部位分别为骶尾部、足跟及髂嵴；前三位科室分别为ICU、肿瘤内科及神经外科。根据上报性质不同，住院病人HAPU分为两大类，一类为预报难免压疮后发生，第二类为未预报发生；预报难免压疮后发生的HAPU分级严重度低于未预报后发生的病人，差异有统计学意义（P＜0．05），两者预后差异无明显统计学意义（ P＞0．05）。病人自身存在高危因素是导致预报难免压疮后发生HAPU的主要原因，而预防重视不够、措施不到位是导致未预报后发生HAPU的主要原因。结论：护理管理者应提高护士的压疮风险预测及评估意识，并根据HAPU发生的特点制定针对性的预防措施。

Objective：To analyze the causes and characteristics of hospital-acquired pressure ulcer,and explore preventive strategies for prevention of this incidence.Methods：The incidence of hospital-acquired pressure ulcer（HAPU） was retrospectively analyzed in 69 inpatients reported between 2012 and 2013 in a grade A class Ⅲ hospital,with regard to the age levels,locations,units,degrees,prognosis and root causes.Results：According to the incidence rate of hospital-acquired pressure ulcer,the top three age levels were older than 89 years,range in age from 80 to 89 years and 70 to 79 years.The locations were associated with sacrococcygeal region,heel and iliac crest,and the prevalence was most in Intensive Care Unit （ICU）,Oncology Dept.and Neurosur-gical Dept.By the report categories,one incidence of HAPU was involved in under-estimation and the second in failure submission ,and the degrees of the former incidence was less severe than latter,which had statistical difference（P〈0.05）,whereas the prognosis of the two was not significant（P〉0.05）. The under-estimated incidence of the HAPU was primarily associated with the highly underlying risk factors of the patients ,and the failure submission with inadequate attention and insufficient measures.Conclusion：Nursing administrators should improve the awareness of the nurses′in estimating the risk fac-tors and potential incidence of HAPU,and direct preventive measures in practice on the incidence nature basis.