环节管理在NICU医疗器械性压疮预防中的应用效果

Application effect of link management in prevention of medical device related pressure ulcers in NICU

目的：探讨NICU医疗器械性压疮环节管理,通过各环节管理,达到降低NICU医疗器械性压疮的发生率。方法选取2012年6月—2014年5月726例患者作为对照组,采用常用的预防措施、常规的压疮分期进行护理。另收集2014年6月—2016年5月869例患者作为观察组,观察组在对照组护理的基础上,进行各环节干预：通过成立科室压疮督导小组进行干预、制定常用仪器设备相关压疮的护理措施、建立预防和管理医疗器械相关压疮的管理总则、加强人员培训考核及制定各级职责,观察医疗器械性压疮的发生率。结果对照组发生医疗器械相关性压疮28例,发生率为3.9％,观察组发生医疗器械相关性压疮7例,发生率为0.8％；对照组压疮发生的严重程度高于观察组,创面的治愈率低于观察组,差异有统计学意义（ U＝－2.001,〈0.05）；培训后护理人员对医疗器械相关压疮知识掌握情况总分为（26.2±1.7）分,高于培训前（17.6±0.8）分,差异有统计学意义（t＝－6.04,〈0.01）。结论通过对医疗器械相关压疮的环节管理,降低了医疗器械性压疮的发生率,提高了护理质量,规范了医疗器械的使用,更新了护士对医疗器械压疮护理的新理念。

Objective To explore the link management of medical device related pressure ulcers in neonatal intensive care unit （ NICU） , and reduce the incidence of NICU medical device related pressure ulcers through various link management. Methods From June 2012 to May 2014, 726 cases of patients in our department were selected as the control group and received commonly used preventive measures and conventional pressure ulcer grading nursing care. From June 2014 to May 2016, another 869 patients in our department was selected as the observation group, and they received link intervention based on the routine nursing method which includes the establishment of pressure ulcer steering group, developing nursing measures of common medical device related pressure ulcers, establishing management principles of prevention and management of medical devices related pressure ulcers and strengthening personnel training and development of all levels of responsibility.The incidence rate of NICU medical device related pressure ulcers was observed. Results There were 28 cases of medical device related pressure ulcers in the control group, and the incidence rate was 3. 9%（ 28/726）;while there were 7 cases of medical instrument pressure ulcers in the observation group, and the incidence rate was 0.8% （7/869）. The severity of pressure ulcer in the control group was significantly higher than that in the observation group; the cure rate of the wound was significantly lower than that of the observation group （U=-2.001,P〈0.05）. The score of nursing staff on the knowledge of medical device related pressure ulcers was （26.2±1.7） after training, which was higher than that before training （17.6± 0.8） （t=-6.04,P〈0.01）.Conclusions Through the link management of medical device related pressure ulcers, incidence rate of pressure ulcers is reduced;the quality of nursing is improved; the use of medical equipment is standardized;and the new concept of medical device related pressure ulcers is updated.