基于证据的集束化护理预防危重新生儿压疮的实践

Evidence based practice in the use of critical neonates pressure ulcer prevention

目的探讨基于证据构建的集束化护理在NICU危重新生儿压疮预防中的效果。方法将2015年1~12月收治的2026例危重新生儿作为对照组,应用常规护理方法;将2016年1~12月收治的2268例危重新生儿作为观察组,应用基于证据的集束化护理方案(包括新生儿皮肤风险评估、自制水枕、新型敷料、体位护理、人员培训等);比较两组新生儿校正压疮发生率。结果对照组新生儿中24例发生压疮,校正压疮发生率为8.66%,观察组中6例发生压疮,校正压疮发生率为1.58%;观察组压疮发生率明显低于对照组(P<0.05)。结论运用循证及质量持续改进的方法,构建成整体的、系统的及操作性强的集束化护理方案,可降低NICU危重新生儿压疮的发生率,提高护理质量,值得临床应用。

Objective To evaluate the effect of evidence based bundle care in the prevention of neonatal pressure ulcer in NICU.Methods 2026 cases of critically ill newborns received from January 2015 to December 2015 were treated as control group,and routine care.2268 cases of critically ill newborns received from January 2016 and December 2016 were treated as observation group,the application of evidence-based bundle care(including neonatal skin risk assessment,water pillow,new dressing,body position nursing,personnel training,etc.),compare two groups of neonatal incidence of pressure ulcers.Result In the control group 24 cases of pressure ulcers,calibration of 8.66%incidence of pressure ulcers,6 cases in observation group pressure ulcers,correcting the incidence of pressure ulcers was 1.58%;the incidence of pressure ulcers observation group was obviously lower than that of control group(P<0.05).Conclusion Using the method of evidence-based quality and continuous improvement,building into the overall and systematic,strong operability of bundle care,reduces the NICU critically ill newborn incidence of pressure ulcers,improve the quality of nursing,worthy of clinical application.