神经外科患者术中获得性压力性损伤的多学科团队链式管理

Chain management based on multidisciplinary teamwork for intraoperative acquired pressure injury in neurosurgical patients

目的探讨多学科团队链式管理在预防神经外科术中获得性压力性损伤中的效果。方法将2019年1~10月神经外科患者作为对照组,实施常规的术中获得性压力性损伤管理;2019年11月至2020年9月患者作为干预组,实施包括成立多学科围术期术中获得性压力性损伤链式管理小组、优化临床路径、行跨学科交接班链式管理。结果干预组高危手术体位安置规范率、术中防护措施达标率显著高于对照组(均P<0.01);术中获得性压力性损伤发生率显著低于对照组(P<0.01)。结论多学科团队链式管理能有效促进术中获得性压力性损伤闭环措施落实,降低神经外科术中压力性损伤发生率。

Objective To explore the effect of chain management based on multidisciplinary teamwork for intraoperative acquired pressure injury in neurosurgical patients.Methods Totally,patients undergoing neurosurgery from January 2019 to October 2019 were selected as the control group,who received conventional management for intraoperative acquired pressure injury,and patients undergoing neurosurgery from November 2019 to September 2020 were selected as the intervention group,who was subjected to perioperative acquired pressure injury management led by a multidisciplinary team,which optimized the clinical pathway,and implemented inter-disciplinary chain management in shift handovers.Results The intervention group had higher implementation rate of correct surgical position placement and rate of correct usage of intraoperative protective measures(P<0.01 for both).The overall incidence rate of intraoperative acquired pressure injury in the intervention group were significantly lower than in the control group(P<0.01).Conclusion Chain management based on multidisciplinary teamwork can boost close-looped implement of preventive measures for intraoperative acquired pressure injury,thus reducing the incidence rate of intraoperative acquired pressure injury in neurosurgical patients.