基于SSKIN集束化方案的俯卧位通气患者面部压力性损伤护理方案的构建

Construction of nursing scheme for facial pressure injury of patients with prone position ventilation based on SSKIN cluster scheme

目的构建基于SSKIN集束化方案的俯卧位通气(PPV)患者面部压力性损伤护理方案,为临床护理实践提供指导。方法以SSKIN集束化方案为指导,总结现有研究证据,初步构建PPV患者面部压力性损伤护理方案。于2021年8—9月选取19名护理专家进行2轮德尔菲专家函询,根据专家意见对方案条目进行修改。结果2轮专家函询均发放问卷19份,回收有效问卷19份,有效回收率均为100.00%;专家权威系数均为0.85;第2轮专家函询各条目重要性和可操作性肯德尔和谐系数分别为0.48、0.41(P均<0.01)。最终形成PPV患者面部压力性损伤护理方案包括5个框架,即皮肤评估、支撑面、体位变换、潮湿处理、营养支持,共27个条目。结论本研究构建的基于SSKIN集束化方案的PPV患者面部压力性损伤护理方案具有科学性、可行性和较强的临床实用价值,能够为临床护理实践提供指导。

Objective To construct the nursing scheme for facial pressure injury of patients with prone position ventilation(PPV)based on surface,skin inspection,keep moving,incontinence/moisture,nutrition(SSKIN)cluster scheme,so as to provide guidance for clinical nursing practice.Methods Under the guidance of SSKIN cluster scheme,the existing research evidence was summarized and the nursing scheme of facial pressure injury in patients with PPV was preliminarily constructed.From August to September 2021,a total of 19 nursing experts were selected for two rounds of Delphi expert consultation,and the items of scheme were modified according to the expert opinions.Results In the two rounds of expert letter inquiries,19 questionnaires were distributed and 19 valid questionnaires were recovered.The effective recovery rate was 100.00%and the expert authority coefficient were all 0.85.The Kendall's harmony coefficients of the importance and operability of the items in the second round of expert letters were 0.48 and 0.41 respectively(all P<0.01).Finally,the nursing scheme for PPV patients with facial pressure injury was formed,including 5 frameworks,namely skin evaluation,support surface,body position change,moisture treatment and nutritional support,with a total of 27 items.Conclusions The nursing scheme of PPV patients with facial pressure injury based on SSKIN cluster scheme constructed in this study has scientific,feasible and strong clinical practical value,which can provide guidance for clinical nursing practice.