骨折合并特重度烧伤的护理风险评估与防范措施

Nursing Risk Assessment and Preventive Measures of Fractures with Extremely Severe Burns

目的:评估骨折合并特重度烧伤患者的护理风险并提出防范措施。方法:选取2019年6月-2023年6月笔者医院收治的83例骨折合并特重度烧伤患者为研究对象,采用随机数字表法将纳入患者分为对照组(n=41)和观察组(n=42)。对照组给予常规护理措施,观察组在对照组基础上行护理风险评估,并实施针对性防护措施。比较干预3周后两组护理知识掌握情况、心理状态、健康行为遵守情况、生活质量及护理满意度。结果:干预3周后,两组翻身方法、营养支持、危险因素、好发部位及预防方法评分均明显升高(P<0.05),且观察组各评分明显高于对照组(P<0.05);两组领悟社会支持量表评分均明显升高(P<0.05),汉密顿焦虑量表和汉密顿抑郁量表评分均明显降低(P<0.05),且观察组各评分与对照组比较差异有统计学意义(P<0.05);观察组保护受压部位、保持皮肤清洁、定期翻身、及时更换衣物所占比例均高于对照组(P<0.05);两组一般健康状况、心理状态、躯体功能、社会功能评分及生活质量总分均明显升高(P<0.05),且观察组各评分明显高于对照组(P<0.05);观察组护理总满意率为95.24%,明显高于对照组的80.49%(P<0.05)。结论:积极对骨折合并特重度烧伤患者进行护理风险评估并制定预防措施可有效改善其护理知识掌握情况、心理状态、健康行为遵守情况,利于提高患者生活质量及护理满意度,值得推广应用。

Objective To evaluate the nursing risks of patients with fractures complicated with extremely severe burns and to propose the preventive measures.Methods 83 patients with fractures complicated with extremely severe burns admitted to Tangdu Hospital Air Force Medical University from June 2019 to June 2023were selected as the observation subjects,and the included patients were divided into control group(n=41)and observation group(n=42)by the random number table method.The control group was given routine nursing measures,and the observation group was given nursing risk evaluation on the basis of the control group.After 3weeks of intervention,the two groups were compared in terms of nursing knowledge mastery,psychological state,health behavior compliance,quality of life and nursing satisfaction.Results After 3weeks of intervention,the scores of turning over method,nutritional support,risk factors,predilection site and preventive methods were significantly increased in both groups(P<0.05),and the scores in observation group were significantly higher than those in control group(P<0.05).Perceived social support scale score was significantly increased in both groups(P<0.05)while Hamilton anxiety scale score and Hamilton depression scale score were significantly decreased(P<0.05),and there were significant differences in scores between observation group and control group(P<0.05).The proportions of protecting the pressured part,keeping the skin clean,turning over regularly and changing clothes in time were significantly higher in observation group than those in control group(P<0.05).The scores of general health status,psychological status,physical function and social function and total score of quality of life in both groups were significantly enhanced(P<0.05),and the scores in observation group were significantly higher than those in control group(P<0.05).The total nursing satisfaction rate of the observation group was 95.24%,which was significantly higher than 80.49%of the control group(P<0.05).Conclusion Active nursing risk assessment and preventive measures for patients with fractures and extremely severe burns can effectively improve the nursing knowledge mastery,psychological state and health behavior compliance,and it is conducive to improving the quality of life and nursing satisfaction of patients.