目标管理在预防手术患者术中压疮的应用效果

Application of target management on pressure ulcer prevention in surgical patients

目的 探讨目标管理在预防手术患者术中压疮中的作用.方法 选取2013年1月-2015年12月行择期手术治疗的手术患者作为研究对象,其中2013年1-12月手术患者实施预防压疮常规护理,2014年1月-2015年12月手术患者给予目标管理法预防压疮.比较目标管理发实施前后患者压疮发生率、压疮高风险患者压疮发生率、俯卧位手术患者压疮年发生率、压疮分期分布等.结果 2013、2014、2015年压疮年发生率分别为0.23%、0.11%、0.07%,2014、2015年压疮发生率均低于2013年,差异有统计学意义（x2值分别为24.23、43.32;P〈0.05）;2013、2014、2015年压疮高风险患者压疮发生率分别为21.02%、17.72%、11.68%,2013年压疮高风险患者压疮发生率高于2014年,但差异无统计学意义（χ^2=1.37,P〉0.05）;2013、2014年压疮高风险患者压疮发生率均高于2015年,差异有统计学意义（x2值分别为13.00、4.88;P〈0.05）.2013、2014、2015年俯卧位手术患者压疮发生率分别为6.00%、3.53%、1.06%,2014、2015年压疮发生率均低于2013年,差异有统计学意义（χ^2值分别为7.63、47.05;P〈0.05）.结论 实施目标管理,能够降低手术患者术中压疮发生率、压疮高风险患者压疮发生率及俯卧位手术患者压疮发生率,保证患者安全,提高手术室护理质量.

Objective To explore the effects of target management on pressure ulcer prevention in surgical patients.Method The patients with selective operation were selected as study objects from January 2013 to December 2015. The traditional nursing for pressure ulcer prevention was carried out for operation patients from January 2013 to December 2013. The target management for pressure ulcer prevention was carried out for operation patients from January 2014 to December 2015. And then, we compared the incidence of pressure ulcer, that of patients with high risk of pressure ulcer, annual incidence rate of pressure ulcer of patients with lying position for surgery, distribution of ulcer stage and so on before and after target management. Results The annual incidence rate of pressure ulcer of 2013, 2014, 2015 was 0.23%, 0.11%, 0.07%. The incidence rate of pressure ulcer of 2014 and 2015 was lower than that of 2013 with significant differences （χ^2=24.23, 43.32 ;P〈0.05）. The incidence rate of pressure ulcer of patients with high risk of pressure ulcer in 2013, 2014, 2015 was 21.02%, 17.72%, 11.68%. The incidence rate of pressure ulcer of patients with high risk of pressure ulcer in 2013 was higher than that in 2014 , the difference was not significant（χ^2=1.37, P〉0.05）. The incidence rate of pressure ulcer of patients with high risk of pressure ulcer in 2013 and 2014 was also higher than that in 2015 with significant differences （χ^2=13.00,4.88;P〈0.05）. At the same time, the incidence rate of pressure ulcer of patients with lying position for surgery in 2013, 2014, 2015 was 6.00%, 3.53%, 1.06%. The incidence rate of pressure ulcer of patients with lying position for surgery in 2014 and 2015 was lower than that in 2013 with significant differences （χ^2=7.63,47.05;P〈0.05）.Conclusions The implementation of target management can reduce the incidence of pressure ulcer, that of patients with high risk of pressure ulcer, that of patients with lying position for surgery, guarantee the safety of patient and improve the quality of nursing care in operating room.