一种多功能支撑枕的创新设计与临床模拟应用效果研究

Investigation on innovative design of a multifunctional support pillow and its clinical simulation application effect

目的为降低压力性损伤的发生率,减少长期卧床留置导管患者引流管打折、压迫或脱出的发生,最大程度满足不同患者病情所需求的翻身角度,同时方便患者清洗、收纳与携带,设计一种可灵活充气调控的多功能支撑枕,实现有效翻身,减少压力性损伤、非计划拔管的发生,易清洗、便携度好的主要功能。方法依据重力学原理、气压传动的工作原理,借鉴临床上常用的气垫床、翻身枕等特性,设计一款通过三级空气阀可灵活调控充气角度、顶端设有2个可放置引流管直径12 cm弧形凹槽的新型多功能支撑枕,并进行临床模拟应用及问卷调查,以评价应用效果。结果医护人员均认为应用多功能支撑枕能有效减少压力性损伤、非计划性拔管的发生,该多功能支撑枕的多功能性、舒适性、安全性、通用性、便携性、灵活性认可率>97%,且94%的同行认为该多功能支撑枕的应用,不会增加患者费用及心理负担,并且有利于减少医护人员压疮、非计划性拔管等不良事件上报和处理相关工作量。结论多功能支撑枕能最大程度地减少压力性损伤及非计划拔管的发生,尤其适用于长期卧床留置导管的患者,实现皮肤在长期卧床状态下的保护功能,保证引流管在位与引流通畅,保障患者安全。

Objective Aiming to reduce the incidence of pressure injury,reduce the compression or detachment of drainage tube in patients with long-term lying in bed,meet the needs of different patients to the greatest extent,and facilitate the patients to clean,storage and carry,a multifunctional support pillow with flexible inflation control has been designed.This multifunctional support pillow has several advantages,including realizing effective turning over and reducing the occurrence of pressure damage and unplanned extubation,easy cleaning and good portability.Methods This work combine the principle of gravity and pneumatic transmission with the characteristics of air cushion bed and turn over pillow commonly used in clinic.Based on the above issues,we design a novel multi-functional support pillow which can flexibly adjust the inflation angle through three-stage air valve and has two arc grooves at the top that can place the drainage tube with a diameter of 12 cm.Besides,clinical simulation application and questionnaire survey were carried out to evaluate the application effect.Results It is generally accepted by the medical staff that the application of multi-functional support pillow can effectively reduce the occurrence of pressure injury and unplanned extubation.The multifunctional support pillow has the approval rate of>97%in terms of versatility,comfort,safety,versatility,portability and flexibility.94%of the counterparts believe that the application of the multifunctional support pillow is low-cost,and will not increase the psychological burden of patients.Moreover,it is beneficial to reduce the workload of reporting and handling adverse events of medical staff,such as pressure ulcer and unplanned extubation.Conclusion The multifunctional support pillow can minimize the pressure injuries and unplanned extubation.It is especially suitable for the long-term bedridden indwelling catheters patients.Notably,it can realize the protection function for the skin in long-term bed state,ensure that the drainage tube is in place and the drainage is unobstructed,and ensure the safety of patients.