围手术期压力性损伤链式管理方案在颅脑损伤仰卧位手术患者中的应用

Application of chain management of perioperative pressure injury in patients undergoing supine craniocerebral injury

目的探讨围手术期压力性损伤链式管理方案在颅脑损伤仰卧位手术患者中的应用效果, 为压力性损伤的预防及链式管理方案的应用提供参考。方法采用回顾性研究方法, 将山西省心血管病医院2019年12月至2020年12月收治的116例颅脑损伤仰卧位手术患者纳入对照组, 采用传统围手术期压力性损伤管理方案, 2021年1—12月收治的124例颅脑损伤仰卧位手术患者纳入观察组, 采用围手术期压力性损伤链式管理方案。统计2组患者压力性损伤风险评估/判断率、风险评估/判断准确率、干预措施执行率、干预记录合格率、高危风险患者上报率;调查2组患者压力性损伤发生及医疗费用情况。结果观察组患者压力性损伤风险评估/判断率、风险评估/判断准确率、干预措施执行率、干预记录合格率、高危风险患者上报率分别为100.00%(124/124)、96.77%(120/124)、92.74%(115/124)、93.55%(116/124)、100.00%(29/29), 高于对照组的77.59%(90/116)、72.41%(84/116)、68.97%(80/116)、68.97%(80/116)、83.33%(30/36), 差异均有统计学意义(χ2值为22.24~31.17, 均P<0.05)。对照组和观察组患者压力性损伤总体发生率分别为15.52%(18/116)、3.23%(4/124), 2组比较差异有统计学意义(χ2=10.88, P<0.05)。观察组患者压力性损伤相关费用为(144.94 ± 47.28)元, 低于对照组的(194.21 ± 55.76)元, 差异有统计学意义(t=7.40, P<0.05)。2组患者住院总费用比较差异无统计学意义(P>0.05)。结论围手术期压力性损伤链式管理方案可降低颅脑损伤仰卧位手术患者压力性损伤发生率, 改善服务质量, 降低医疗成本, 有较好的临床应用价值。

Objective To investigate the value of chain management of perioperative pressure injury in patients undergoing supine craniocerebral injury,so as to provide reference for the prevention of pressure injury and the application of chain management.Methods In this retrospective study,a total of 116 patients with craniocerebral injury who underwent supine surgery in Shanxi Cardiovascular Hospital from December 2019 to December 2020 were included in the control group,using traditional perioperative pressure injury management protocol.And 124 patients admitted from January 2021 to December 2021 were included in the observation group,and were managed by the pressure injury chain management scheme.The risk assessment/judgment rate of pressure ulcers,the risk assessment/judgment accuracy rate of pressure ulcers,the implementation rate of intervention measures,the qualified rate of intervention records and the reported rate of high-risk patients with pressure ulcers in the two groups were analyzed.The occurrence of stress injury and medical expenses of the two groups of patients were investigated.Results The risk assessment/judgment rate of pressure ulcers,the risk assessment/judgment accuracy rate of pressure ulcers,the implementation rate of intervention measures,the qualified rate of intervention records and the reported rate of high-risk patients with pressure ulcers were 100.00%(124/124),96.77%(120/124),92.74%(115/124),93.55%(116/124),100.00%(29/29)in the observation group,which were 77.59%(90/116),72.41%(84/116),68.97%(80/116),68.97%(80/116),83.33%(30/36)in the control group,the difference was statistically significant(χ2 values were 22.24-31.17,all P<0.05).The overall incidence of stress injury in the observation group and the control group was 15.52%(18/116)and 3.23%(4/124),respectively,and the difference between the two groups was statistically significant(χ2=10.88,P<0.05).There was no significant difference in the total hospitalization cost between the two groups(P>0.05).The cost of stress-related consumables was(144.94±47.28)yuan in the observation group and(194.21±55.76)yuan in the control group,and the difference was statistically significant(t=7.40,P<0.05).Conclusions Perioperative stress injury chain management can reduce the incidence of pressure injury in patients with craniocerebral injury,improve service quality,and reduce medical costs,with good clinical application value.