分层级管理模式在脊柱外科压疮护理中的应用

Level Management Model in the Application of Nursing for Pressure Ulcers after Spinal Surgery

目的探讨分层级管理模式在脊柱外科压疮护理中的应用效果。方法纳入2014年1月-2015年9月的脊椎外科患者共3 558例。建立压疮分级管理系统,制定各层次人员的岗位职责,强化新入院患者压疮危险因素评估,规范压疮上报处置流程。2014年1月-6月试行分层级管理压疮模式;2014年7月-12月进行经验总结,形成系统文件实施;2015年1月-9月继续完善,持续改进后应用于临床。对各个阶段的高危压疮上报率、院内压疮发生率、已患压疮治愈率进行比较分析。结果持续改进后,脊柱外科高危压疮上报率上升,压疮现患率较前降低而压疮治愈率提高(P<0.05)。结论分层级管理模式有效提高了脊柱外科压疮护理质量,得到医生、护士、患者的一致认可。

Objective To explore the effect of level management model in the application of nursing for pressure ulcers after spinal surgery.Methods A total of 3 558 patients underwent spinal surgeries between January 2014 and September 2015 were selected.We established a level management model,confirmed the personnel responsibilities,strengthened the pressure ulcers risk assessment of new inpatients,and standardized the processes of reporting pressure sores.We carried out the level management model between January and June 2014,summarized experience and formed a system file between July and December 2014,applied to the clinical work after continuous improvement between January and September 2015.High risk of pressure ulcers reporting rate,incidence of high-risk pressure ulcers,and healing rate of pressure ulcers were compared at the various stages.Results The reporting rate of pressure ulcers raised,the incidence of pressure ulcers increased and the curing rate decreased after continuous improvement（P〈 0.05）.Conclusion Level management model may effectively improve the quality of the nursing for spinal pressure ulcers.