链式管理预防术中获得性压力性损失的基层护理实践

Grassroots management practice of chain management in preventing intraoperative acquired pressure injury

目的运用链式管理的方法构建预防术中获得性压力性损伤全程管理体系并分析其成效。方法选择2022年6月17日—2023年8月9日在本院进行外科手术,术前评估风险为高危以及存在独立危险因素的120例患者作为研究对象,运用链式管理的理念进行术后护理。对纳入对象从术前、术中、术后以及转至病区、重症监护室后进行全程交接和管理,形成闭环结构。结果经过链式管理,120例患者中共有14例术后存在皮肤压红的现象,皮肤压红率为11.67%。单因素分析结果显示,性别、手术体位、手术时长、年龄、血清白蛋白含量是患者是否发生皮肤压红的影响因素(P<0.05);多因素分析结果显示手术时长、患者年龄、血清白蛋白含量是影响患者皮肤压红的因素(P<0.05),未有手术患者发生术中获得性压力性损伤。结论运用链式管理的理念,多学科、多团队全程对手术患者进行皮肤管理,有效降低了术中获得性压力性损伤的发生率,提升了护理质量。

Objective To construct a comprehensive management system for the prevention of intraoperative acquired pressure injury by using a chain management approach and analyzing its effectiveness.Methods Totally,120 patients who underwent surgical procedures from June 17,2022 to August 9,2023 in our hospital and were assessed as high-risk and had independent risk factors before surgery were selected as study subjects.Using the concept of chain management,high-risk patients were handed over and managed throughout the entire process from preoperative,intraoperative,postoperative,transferring to ward and ICU,forming a closed-loop structure.Results After chain management,a total of 14 out of 120 surgical patients experienced postoperative skin redness,with a skin redness rate of 11.67%.The results of univariate analysis showed that gender,surgical position,surgical duration,age,and serum albumin content were the influencing factors for whether patients experienced skin redness(P<0.05).The results of multivariate analysis showed that surgical duration,patient age,and serum albumin content were the influencing factors for skin redness(P<0.05),and no surgical patients experienced intraoperative acquired stress injury.Conclusions By using the concepts of chain management,multi-disciplinary and multi team skin management for surgical patients throughout the process effectively reduces the incidence of acquired stress injury during surgery and improves the quality of care.