基于链式流程的手术患者压力性损伤信息平台构建

Construction of pressure injury information system for patients with surgery based on chain-type process

目的探讨如何运用信息平台优化手术患者的压力性损伤管理流程。方法建立基于链式流程的手术患者一体化压力性损伤管理信息平台，对关键环节加以控制，实现手术患者从入院到出院的多环节全程监控。本研究以手术患者压力性损伤链式流程为切入点，在试点手术科室选取l240例患者为研究对象，其中2016年5月信息平台运行前578例患者为对照组，2017年5月信息平台运行后662例为观察组。比较信息平台运用前后压力性损伤评估单合格率、高危压力性损伤及带入压力性损伤患者筛选上报准确率、转运交接皮肤情况描述相符率、院内压力性损伤发生率、手术患者1期，2期及以上压力性损伤发生率。结果观察组压力性损伤评估单合格率为99．24％，高危压力性损伤筛选上报准确率为100．00％，转运交接皮肤描述相符率为100．00％，均高于对照组，差异有统计学意义（P〈0．05）。观察组手术患者院内压力性损伤发生率2．95％，手术患者1期压力性损伤发生率2．65％，对照组为6．51％、5．82％，两组比较差异有统计学意义（P〈0．05）。结论基于链式流程的手术患者一体化压力性损伤管理信息平台，实现了对患者皮肤全程、连续、准确、动态评估与监控，有效提高压力性损伤护理的质量，便于护理管理人员不断进行持续改进。

Objective To explore how to optimize management process of pressure injury for surgery patients by applying information system. Methods We built an integrated surgery patients pressure injury management informalion system based on chain-type process along with controlling key links and realizing monitoring in a whole process and many links for surgery patients from be hospitalized to leave hospital. This research took the surgery patients pressure injury chain-type process as a breakthrough and selected 1 240 patients as subjects in experimental operating room. A total of 578 patients were in control group in May 2016 before implementing information system and 662 patients were in observation group in May 2017 after implementing information system. We compared the qualified rate of pressure injury assessment, accuracy rate of screen for patienls with high-risk pressure injury and being with pressure injury, accordance rate of description in skin condition during transportation and handover, the incidence of pressure injury in hospital and surgery patients in the first stage, the second stage and above. Results The qualified rate of pressure injury assessment, accuracy rate of screen for patients with high-risk pressure injury, accordance rate of description in skin condition during transportation and handover of observation group was 99.24%, 100% and 100.00% significantly higher than those of control group （P 〈 0.05）. The incidence of pressure injury in hospital and in the first stage of surgery patients was 2.95% and 2.65% in observation group with significant differenees compared with those in control group （6.51%, 5.82%）（P 〈 0.05）. Conclusions The integrated surgery patients pressure injury management information system based on chain-type process realizes a full, continuous, accurate, dynamic evaluation and monitoring for patients＇ skin. It can effectively improve the nursing quality of pressure injury and is convenient for managers to carry out a continuous improvement.