ICU患者压力性损伤预防的循证实践

Evidence-Based Practice in Prevention of Pressure Injury in ICU Patients

目的 将ICU患者压力性损伤预防的最佳证据应用于临床实践并评价其效果。方法 以证据持续质量改进模型为研究框架进行临床转化,包括证据获取、现状审查、证据引入和效果评价4个阶段,比较证据应用前后ICU医护人员对患者压力性损伤预防的知识水平、对审查指标的执行率和ICU患者压力性损伤的发生率。结果 最佳证据应用后,ICU医护人员对压力性损伤预防的知识水平由(63.39±13.10)分上升至(90.24±9.11)分,差异有统计学意义(P<0.001);最佳证据应用后,21条审查指标的执行率由0%~100%上升至75%~100%;ICU患者压力性损伤的发生率从7.23%下降至1.16%,差异有统计学意义(P<0.005)。结论 将基于循证的最佳证据应用于临床实践,可促进ICU患者压力性损伤的预防及管理工作,降低ICU压力性损伤的发生率,提高临床护理质量。

Objective The best evidence of pressure injury prevention in ICU patients was applied to clinical practice and evaluated its effect.Methods The evidence-based continuous quality improvement model was used as the conceptual framework for clinical transformation.It consists of 4 stages including evidence acquisition,current situation review,evidence introduction and after-effect evaluation.The knowledge level of ICU medical staff on the prevention of pressure injury,the implementation of audit indicators and the incidence of pressure injury in ICU patients were compared before and after the application of the evidence.Results After the application of the best evidence,the score for knowledge on the prevention of pressure injury were increased from(63.39±13.10)to(90.24±9.11),the difference was statistically significant(P<0.001).The implementation rate of 21 audit indicators were improved from 0%-100%to 75%-100%.The incidence of pressure injury in ICU patients decreased from 7.23%to 1.16%,the difference was statistically significant(P<0.005).Conclusion Applying the best evidence-based evidence in clinical practice can promote the prevention of pressure injury in ICU patients,reduced the incidence of ICU pressure injury,and improved the quality of clinical care.