术中压疮管控标准化操作流程在术中压疮高危患者中的应用

Application of Standardized Operation Procedure for Intraoperative Pressure Ulcer Management and Control in Patients at High Risk of Intraoperative Pressure Ulcer

目的:探讨术中压疮管控标准化操作流程在术中压疮高危患者中的应用效果。方法:将实施术中压疮管控标准化操作流程前(2017年)术中压疮高危患者1126例作为对照组,实施常规压疮预防措施。实施术中压疮管控标准化操作流程后(2018年)术中压疮高危患者1231例作为观察组,采用参照术中压疮预防相关规范及指南并结合日常实践经验形成的术中压疮管控标准化操作流程进行压疮预防,比较两组手术患者压疮预防工具正确使用率、手术体位摆放合格率及术中压疮发生率。结果:观察组压疮预防工具正确使用率、手术体位摆放合格率高于对照组(P<0.01);2018年手术患者术中压疮发生率降低,且2期以上压疮发生率也降低。结论:术中压疮管控标准化操作流程实现了病房护士、手术室护士、麻醉医生、手术医生、PACU及ICU护士在压疮管理方面全程无缝隙的链条式动态管理,在护理部及医院压疮质控组的参与、监督管理下,摆脱了以前经验式的管理,在此操作流程中手术室护士为主导,上下游科室按流程各负其责,保证手术患者安全。

Objective:To explore the application effect of standardized operation procedure of intraoperative pressure ulcer management and control in patients with high risk of intraoperative pressure ulcer.Methods:A total of 1126 patients with high risk of intraoperative pressure ulcers were selected as the control group before the implementation of the standardized operation procedure of intraoperative pressure ulcers management and control(2017),and routine pressure ulcers prevention measures were implemented.A total of 1231 patients with high risk of intraoperative pressure ulcers were selected as observation group after the implementation of the standardized operation procedure of intraoperative pressure ulcers management and control(2018).The standardized operation procedure of intraoperative pressure ulcers management and control with reference to pressure ulcers prevention related norms and guidelines combined with the daily experience was used to prevent intraoperative pressure ulcers.The surgical patients with pressure ulcers prevention tools application rate,qualified rate of surgical body position and incidence of intermediate pressure ulcers were compared between the two groups.Results:The correct application rate of pressure ulcer prevention tools and the qualified rate of surgical position were higher in the observation group than in the control group(P<0.01).In 2018,the incidence of intraoperative pressure ulcers was decreased,and the incidence of pressure ulcers above stage 2 was also decreased.Conclusion:The application of standardized operation procedure for intraoperative management and control has achieved whole process seamless chain dynamic management among the ward nurses,operating room nurses,anesthesia doctors,operation doctors,PACU and ICU nurses in pressure ulcer management.Under the participation and the supervision of nursing department and hospital quality control group,it has got rid of the previous empirical management.In this operation process,the operating room nurses take the lead,and the upstream and downstream departments take their respective responsibilities according to the process to ensure the safety of surgical patients.