老年压疮高危病人卧减压床垫翻身间隔时间的循证实践

Evidence-based nursing practice of repositioning schedule for preventing pressure injury among elderly patients lying on pressure-relieving mattress

目的总结老年压疮高危病人卧减压床垫翻身间隔时间的相关证据,并验证证据的安全性与可行性。方法选取2018年3～6月于南京医科大学第一附属医院老年神经内科住院的老年病人50例,试验组和对照组各25例,试验组按照循证证据每4 h翻身1次,对照组按照护理常规每2 h翻身1次。通过比较2组的压疮发生率、压疮前期症状发生率、护理工作量及病人的满意度评价2种翻身间隔时间的压疮预防效果与可行性。结果试验组和对照组病人均未出现压疮; 2组压疮前期症状发生率差异无统计学意义(χ2=0. 272,P=0. 602);试验组的护理工作量及病人满意度均高于对照组(t=-47. 413,P<0. 001;χ2=4. 504,P=0. 034)。结论对于卧减压床垫的老年压疮高危病人,相比2 h一次的翻身间隔时间,每4 h一次的翻身并不增加压疮发生风险,但却能减少护理工作量,并有利于提高病人的满意度。

Objective To summarize the evidence of repositioning schedule among the elderly patients at risk of pressure injury lying on pressure-relieving mattress and to verify the safety and feasibility of the evidence.Methods A total of fifty elderly patients in Department of Geriatric Neurology,the First Affiliated Hospital of Nanjing Medical University from March to June 2018 were divided into experimental group and control group,with 25 cases in each group.The patients in experimental group were turned every 4 hours based on evidence and the patients in control group were turned every 2 hours based on routine nursing.The effects of different repositioning time on the prevention of pressure injury were assessed by comparing the pressure injury and pressure injury pre-performance incidences,the nursing workload in repositioning and the patients satisfaction between the two groups.Results No pressure injury occurred in two groups,and there was no significant difference in the pressure injury pre-performance incidence between the two groups(χ^2=0.272,P=0.602).The nursing workload and the patients satisfaction in experimental group were all significantly higher than those in control group(t=-47.413,P<0.001;χ^2=4.504,P=0.034).Conclusions The 4-hour repositioning is not related to pressure injury risk and can reduce nursing workload and improve the elderly patients satisfaction.