通过“医养结合”模式降低敬老院压疮发生率的探索

Exploration of reducing the incidence of the elderly pressure sores at nursing home by “integration of medical service and aged service”

目的:探索"医养结合"模式下护理干预对提高敬老院护理员压疮相关知识和降低压疮发生率的效果。方法:2017年2月采用随机抽样法抽取敬老院内卧床老年患者60例和护理员20名,开展为期9个月的压疮知识、技能培训及现场干预指导。采用自制问卷调查干预前后护理员的压疮知识知晓率和护理技能变化以及老年患者对护理员的满意度。结果:护理员的压疮知识知晓率由干预前的22.86%升至干预后的89.28%,护理技能从30.63%升至86.25%,均较干预前明显提高(P <0.01)。干预期间60例老年患者均未发生压疮,患者对护理员满意度从干预前的54.4%提高至干预后的80.0%。结论:对敬老院内护理员开展压疮防治知识及技能培训切实有效,可提高护理员的压疮护理水平,有效控制卧床老年患者的压疮发生情况,提高患者生活质量。

Objective: To explore the effect of nursing intervention under the mode of " integration of medical service and aged service " in the improvement of the knowledge of pressure sore of the nursing workers in the nursing home to reduce the incidence of pressure sores. Methods: In February 2017, 60 bedridden elderly patients and 20 nursing workers in the nursing home were selected by random sampling method to conduct nine months of pressure ulcer knowledge, skills training and on-site intervention guidance. The self-made questionnaire was used to investigate the changes of knowledge awareness rate and nursing skills of nursing workers before and after intervention, and the satisfaction degree of elderly patients to nursing workers. Results: The awareness rate of pressure ulcer knowledge among nursing workers increased from 22.86% before intervention to 89.28% after intervention, and nursing skills increased from 30.63% to 86.25%, which were significantly higher than those before intervention ( P < 0.01). No pressure ulcers occurred in 60 elderly patients during the intervention period. The satisfaction of the patients with nursing workers increased from 54.4% before the intervention to 80.0% after the intervention. Conclusion: It is effective to train nursing workers' knowledge and skills of pressure ulcer prevention and treatment in the nursing home, which can improve the nursing workers' pressure sore care level, effectively control the occurrence of pressure sores in bedridden elderly patients, and improve the quality of life of the patients.