持续质量控制对危重患者压疮发生率的影响

Effects of continuous quality control on incidence of pressure ulcers in critically ill patients

目的探讨持续质量控制对危重患者压疮发生率的影响,为其临床预防提供可参考依据。方法共纳入170例ICU病房的危重症患者作为控制前组,同时应用持续质量改进的管理理念和先进的管理方法,按计划、实施、检查与处理循环的方法实施早期目标控制,选择180例ICU病房的危重症患者作为控制后组,观察2组患者压疮的发生情况。结果持续质量控制后操作技能达标率93.89%及Braden评分复合率83.33%均明显高于持续质量控制前达标率87.64%、复合率73.53%,2组比较差异有统计学意义(P<0.05)。控制前组170例患者中31例患者发生压疮,占18.23%,其中1期13例,占7.65%,2期11例,占6.47%,3期5例,占2.94%,4期2例,占1.18%。控制后组180例患者中8例发生压疮,占4.44%,其中1期5例,占2.78%,2期3例,占1.67%,无3期、4期发生。2组压疮发生情况比较差异有统计学意义(P<0.05)。ICU出院患者中,实施持续质量控制的患者满意率明显升高,且满意度评分亦明显高于实施前,2组比较差异有统计学意义(P<0.05)。结论在ICU病房预防压疮管理中引进持续质量控制,可以有效地提高护理人员压疮护理技能,最大限度降低压疮的发生风险,同时有效提高了患者的出院满意度,值得临床推广应用。

Objective To study the effects of continuous quality control on incidence of pressure ulcers in critically ill patients and provide a reference for clinical prevention .Methods 170 critical patients were included as pre-control group while 180 critical patients were included as post-control group who were applied continuous quality control .The occurrence of patients in pressure ulcers was observed .Results After the applying of continuous quality control , the attainment rate of operation skills was 93.89%and the Braden scale recombination rate was 83.33%,which was higher than that in pre-control group accounting for 87.64% and 73.53% respectively.There were statistically significant differences ( P <0.05).31 patients in pre-control group occurred pressure ulcers ,accounted for 18.23%,which including 13 (7.65%) cases of stage 1, 11(6.47%) cases of stage 2,3(2.94%) cases of stage 3,2(1.18%) cases of stage 4.8 patients in post-control group occurred pressure ulcers,accounted for 4.44%,which including 5(2.78%) cases of stage 1,3(1.67%) cases of stage 2,no stage 3 and 4.There were statistically significant differences ( P <0.05).The patient’ s satisfaction was increasing significantly after applying continuous quality control and its score was obviously higher than that before continuous quality control.There were statistically significant differences ( P <0.05).Conclusion Continuous quality control can effectively improve the pressure ulcers nursing skills , mostly reduce the risk of pressure ulcers occurrence , and improve the patient ’ s satisfaction,which is worth to spread .