Predictive risk scales for development of pressure ulcers in pediatric patients admitted to general ward and intensive care unit

BACKGROUND More than ten special scales are available to predict the risk of pressure ulcers in children.However,the performances of those scales have not yet been compared in China.AIM To compare the Waterlow,Braden Q,and Glamorgan scales,and identify more suitable pressure ulcer evaluation scale for the pediatric intensive care unit(PICU).METHODS Trained nurses used the Waterlow,Braden Q,and Glamorgan scales to assess pediatric patients at Sun Yat-sen Memorial Hospital(China)within 24 h of admission from May 2017 to December 2020 in two stages.Skin examination was carried out to identify pressure ulcers every 3 d for 3 wk.RESULTS The incidence of pressure ulcers was 3/28(10.7%)in the PICU and 5/314(1.6%)in the general pediatric ward.For children in the general ward,the Waterlow,Braden Q,and Glamorgan scales had comparable area under the operating characteristic curve(AUC)of 0.870,0.924,and 0.923,respectively,and optimal cut-off values of 14,14,and 29 points.For PICU,the Waterlow,Braden Q,and Glamorgan scales had slightly lower AUC of 0.833,0.733,and 0.800,respectively,and optimal cut-off values of 13,16,and 27 points.Braden Q demonstrated a satisfactory specificity,and during the second stage of the study for PICU patients,the AUC of the Braden Q scale was 0.810,with an optimal cut-off value of 18.35 points.CONCLUSION The Waterlow,Braden Q,and Glamorgan scales have comparable performance while the Braden Q scale demonstrates a better specificity and can be successfully used by pediatric nurses to identify patients at high risk of pressure ulcers in PICU.

Prevalence and Risk Factors of Postoperative Pressure Ulcers:A Systematic Review and Meta-analysis of Diagnostic Test

[Objectives]The paper was to analyze the total prevalence of postoperative pressure ulcers in patients and to reveal the epidemic law.[Methods]By searching English databases such as PubMed,Google Academics,Scopus,Science Direct and Web of Science(WOS),a total of 2018 English articles on pressure ulcers published from January 2015 to December 2020 were selected.According to the inclusion criteria,19 high-quality literatures were selected for the study,and the extended function of meta-analysis software of Review Manager 5.1 diagnostic test was used for data statistics and meta analysis of the results.[Results]There were 19 literatures with a total of 9400 patients included in the meta-analysis.The results showed that the total prevalence estimate of postoperative pressure ulcers was 20.00%(CI 95%:15.3-24.1).The total prevalence estimate of postoperative pressure ulcers in males was 10.1%(CI 95%:7.2-13.02),and that in females was 12.8%(CI 95%:8.1-17.3).The total prevalence estimates of stage I to IV postoperative pressure ulcers were 17.02%(CI 95%:11.06-22.09),6.7%(CI 95%:3.76-9.69),0.9%(CI 95%:0.21-1.26)and 0.4%(CI 95%:-0.05-0.8),respectively.[Conclusions]The prevalence of postoperative pressure ulcers is generally high.The prevalence of postoperative pressure ulcers in females is higher than that in males,and the prevalence of stage I pressure ulcers is higher than that of other stages,which is related to age,gender and other related risk factors.

Nursing Effects of Medical Treatment Combination on Patients at High Risk of Developing Pressure Ulcers at Rural Homes

Objective:To explore the nursing effects of medical treatment combination on patients at high risk of developing pressure ulcers at rural homes.Methods:From January 2018 to December 2018,86 patients at high risk of developing pressure ulcers at rural homes who were in Wenjiang Hospital were randomly divided into a control group and an observed group.The control group received the routine publicity and education and visiting,while the observed group adopted the cooperative nursing model of medical treatment combination.Then compare the healing status and nursing satisfaction of the two groups.Results:Of the 43 patients with pressure ulcers in the observed group,18 had been in the second stage of pressure ulcers and 16 had been healed;14 had been in the third stage of pressure ulcers and 8 had been healed;11 had been in the fourth stage of pressure ulcers and 5 had been healed.The nursing satisfaction of the patients in the observed group was 95.35%.Conclusion:Conducting medical treatment combination on patients at high risk of developing pressure ulcers at rural homes can effectively improve the patients’and their families’awareness of pressure ulcer nursing,standardize their nursing behaviour,help recover the patients themselves and promote the patients’satisfaction.

Pressure Ulcers in Institutionalized Elderly People:Association of Sociodemographic and Clinical Characteristics and Risk Factors

Objective: To evaluate the association of socio-demographic and clinical characteristics, and risk factors with occurrence of pressure ulcers in institutionalized elderly people. Method: This cross-sectional, analytical study, in quantitative approach, performed from the database analysis linked to the project “Pressure Ulcer in institutionalized elderly people: Association of incidence with the risk factors to functional and nutritional assessment” developed in six long-stay institutions for the elderly people in Jo&atildeo Pessoa. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 20.0. Associations were made through chi square test and Odds Ratio. Results: The clinical conditions of significant associations with the occurrence of pressure ulcers were the variables neurological disorders (p = 0.011) and visual impairment (p = 0.005). As for risk factors, the most important was fecal incontinence (p Conclusion: The analysis of the associations pointed out problems that require intervention in order to prevent health implications of the elderly people and to minimize the risk and occurrence of this injury.

Predictive accuracy of the Braden Q Scale in risk assessment for paediatric pressure ulcer: A meta-analysis

Aims:Paediatric pressure ulcers are a serious problem to healthcare service.Thus,effective and early identification of the risk of developing pressure ulcer is essential.The Braden Q scale is a widely used tool in the risk assessment of paediatric pressure ulcer,but its predictive power is controversial.Hence,we performed a meta-analysis to evaluate the predictive power of the Braden Q scale for pressure ulcer in hospitalised children and offer recommendations for clinical decision.Methods:Studies that evaluated the predictive power of the Braden Q scale were searched through databases in English and Chinese,including Medline,Cochrane Library,Embase,CINAHL,SinoMed,CNKI,Wangfang and VIP.The studies were screened by two independent reviewers.QUADAS-2 was used to assess the risk of bias of eligible studies.Demographic data and predictive value indices were extracted.The pooled sensitivity,specificity and receiver operating characteristics(ROC)were calculated by MetaDiSc 1.4 using random-effects models.Results:Cochran Q=26.13(P=0.0036)indicated the existence of heterogeneity;the I2 for pooled DOR was 61.7%,suggesting significant heterogeneity among the included studies.The pooled sensitivity and specificity were 0.73(95%CI:0.67-0.78)and 0.61(95%CI:0.59-0.63),respectively,yielding a combined DOR of 3.47(95%CI:2-6.01).The area under the ROC curve was 0.7078±0.0421,and the overall diagnostic accuracy(Q*)was 0.6591±0.0337.Sensitivity analysis showed the results were robust.Conclusion:The Braden Q scale has moderate predictive validity with medium sensitivity and low specificity for pressure ulcers in hospitalised children.Further development and modification of this tool for use in paediatric population are warranted.

Translation and piloting of the Chinese Mandarin version of an intensive care-specific pressure injury risk assessment tool(the COMHON Index)

Objective:To translate an intensive care-specific pressure injury risk assessment tool(the COMHON Index)from English into Chinese Mandarin.Methods:A four-step approach to instrument translation was utilised:1)English-Mandarin forward-translation by three independent bilinguists;2)Mandarin-English back-translation by two other inde-pendent bilinguists;3)comparison of forward and back-translations,identification of discrepancies,with required amendments returned to step one;and 4)piloting of the translated instrument.The pilot study was undertaken in a Chinese surgical intensive care unit with a convenience sample of 20 nurses.A five-point ordinal scale(1=very difficult;5=very easy)was used to assess ease-of-use and understanding.Translations were retained where medians4 indicated use and understanding was easy to very easy.Results:Five iterations of steps 1 to 3,and two sets of amendments to the original English instrument,were required to achieve translation consensus prior to pilot testing.Subscale scoring,sum scoring,and risk categorisation were documented in most pilot assessments(≥80%),but three sum scores were incorrectly tallied.The overall tool and all subscales were easy to use and understand(medians≥4),and most assessments(16/20,80%)took5 min to complete.Thus,translations were retained,with minor amendments made to instrument instructions for scoring and risk categorisation.Conclusions:An easy-to-use Chinese Mandarin intensive care-specific pressure injury risk assessment tool has been introduced through cross-cultural translation.However,it requires further testing of interrater reliability and agreement.A rigorous translation and reporting exemplar is presented that provides guidance for future translations.

Predicting Pressure Ulcer Risk with the Braden Q Scale in Chinese Pediatric Patients in ICU

Objective: The purpose of this study was to: ( 1 ) observe the value of the score of Braden Q scale in predicting pressure ulcers in pediatric Intensive Care Unit ( ICU) patients in China, ( 2) determine the critical cutoff point for classifying patient risk, and ( 3) describe the pressure ulcer incidence. Methods: A prospective cohort descriptive study with a convenience sample of 198 patients bed-ridden for at least 24 hours without pre-existing pressure ulcers enrolled from a pediatric intensive care unit ( PICU) . The Braden Q score and skin assessment were independently rated, and data collectors were blinded to the other measures. Patients were observed for up to 3 times per week for 2 weeks and once a week thereafter until PICU discharge. Results: Fourteen patients ( 7. 1%) developed pressure ulcers; 12 ( 85. 7%) were Stage I pres-sure ulcers, 2 ( 14. 3%) were Stage II, and there were no Stage III or IV pressure ulcers. Most pressure ulcers ( 64. 3%) were present at the first observation. The Braden Q Scale has an overall cumulative variance contribution rate of 69. 599%. Using Stage I+ pressure ulcer data obtained during the first observation, a Receiver Operator Characteristic ( ROC) curve for each possible score of the Braden Q Scale was constructed. The area under the curve ( AUC) was 0. 57, and the 95% confidence interval was 0. 50-0. 62. At a cutoff score of 19, the sensitivity was 0. 71, and the specificity was 0. 53. The AUC of each item of the Braden Q Scale was 0. 543-0. 612. Conclusions: PICU patients are susceptible to pressure ulcers. The value of the Braden Q Scale in the studied pediatric population was relatively poor, and it should be optimized before it is used in Chinese pediatric patients.

Risk factors for pressure ulcers in adult patients of cardiac surgery with cardiopulmonary bypass

Pressure ulcers(PUs)are a common complication of surgery.Despite PUs causing a heavy economic burden and diminishing patients’quality of life,their risk factors have not been thoroughly investigated.We aimed to find risk factors for PUs in adult cardiac surgery patients with cardiopulmonary bypass(CPB).Methods:Demographic,laboratory,and surgical data,the score of pressure ulcer(PU)risk tool-Braden Scale of 2307 adult patients who underwent cardiac surgery with cardiopulmonary bypass(CPB)between January 2019 and September 2019 were obtained.The postoperative PU incidence rates were analyzed using binary logistic regression analysis.Receiver operating characteristic curves(ROC)and the areas under the curves(AUC)were calculated to assess the predictive accuracy of PU risk.Results:Of the 2307 patients in this study,176 developed PUs after surgery,PU incidence rate was 7.6%.Univariate analysis showed that sex,emergency status,surgery type,surgery classification,and skin problems before surgery were risk factors for postoperative PUs.In multivariate analysis,emergency surgery,hemoglobin,hematocrit,pro-brain natriuretic peptide(pro-BNP),surgery classification,and skin problems before surgery were risk factors for postoperative PUs.Conclusions:Our findings suggest that emergency surgery,hemoglobin,hematocrit,pro-BNP,surgery classification,and skin problems before surgery are risk factors for PUs in adult cardiac surgery patients with CPB.The widely used Braden Scale is unsuitable for predicting PUs in such patients.

俯卧位通气相关面部压力性损伤危险因素分析及最佳建模方法选择

背景面部压力性损伤是俯卧位通气患者常见并发症,创面局部暴露可增加全身感染风险,影响俯卧位通气治疗效果,甚至造成局部组织永久性功能损害。探讨其危险因素并构建预测模型对于预防俯卧位通气相关面部压力性损伤具有重要临床意义。目的探讨俯卧位通气相关面部压力性损伤的危险因素及其最佳建模方法。方法选择2020年6月—2023年3月入住新疆医科大学第一附属医院重症医学科的159例接受俯卧位通气的患者为研究对象,根据是否发生面部压力性损伤分为压力性损伤组(n=22)和非压力性损伤组(n=137),收集患者的一般信息、疾病诊断、治疗措施、实验室检查。分别使用逐步Logistic回归模型、全变量Logistic回归模型及Lasso-Logistic回归模型筛选面部压力性损伤危险因素并建立预测模型,应用受试者工作特征曲线下面积(AUC)评价模型区分度;应用赤池信息准则(AIC)、贝叶斯信息准则(BIC)及校准曲线评价模型校准度;应用决策曲线评价模型临床应用价值。通过比较三种Logistic回归模型预测效能和临床应用差异选择最佳建模方法。结果逐步Logistic回归模型结果显示,面部压力性损伤的影响因素为年龄(OR=39.041)、糖尿病(OR=7.256)和单次俯卧位通气时间(OR=6.705);全变量Logistic回归模型结果显示,面部压力性损伤的影响因素为年龄(OR=26.882)、糖尿病(OR=1.770)、ICU住院时间(OR=2.610)和单次俯卧位通气时间(OR=5.340);Lasso-Logistic回归结果显示,面部压力性损伤的影响因素为年龄(OR=38.256)、糖尿病(OR=1.094)、单次俯卧位通气时间(OR=5.738)和Richmond躁动镇静评分(OR=1.179)。Lasso-Logistic回归模型预测俯卧位通气相关面部压力性损伤的AUC、灵敏度和特异度分别为0.855、0.959和0.750,优于逐步和全变量Logistic回归模型;AIC和BIC分别为44.634和55.745,低于逐步和全变量Logistic回归模型;校准曲线显示Lasso-Logistic回归模型预测概率与实际概率拟合效果最佳。决策曲线显示Lasso-Logistic回归模型获得临床收益对应风险阈值为0.01~0.98,优于逐步和全变量Logistic回归模型。结论年龄、糖尿病、单次俯卧位通气时长和Richmond躁动镇静评分是俯卧位通气相关面部压力性损伤的危险因素,Lasso-Logistic回归模型预测效能和临床应用价值优于逐步Logistic回归模型和全变量Logistic回归模型,是最佳建模方法。

养老机构压力性损伤危险因素评估量表的编制及信效度检验

目的:编制养老机构压力性损伤(PI)危险因素评估量表,并检验其信效度。方法:回顾性分析文献、半结构式访谈形成量表的条目池,经过专家函询和预调查对各条目进行修订,形成初始量表。选取2022年3—5月河南省4所养老机构的242例居住者进行第1轮问卷调查;另选取2022年6—8月河南省4所养老机构的291例居住者进行第2轮问卷调查。结果:量表最终包含2个维度,9个条目。量表的平均内容效度指数为0.98;探索性因子分析提取出2个公因子,其累计方差贡献率为69.89%;验证性因子分析结果可见量表因子结构稳定;量表总的Cronbach’s α系数、折半信度及重测信度分别为0.852、0.836和0.848;评估量表最佳临界值为19分。结论:养老机构PI危险因素评估量表具有良好的信效度。

PDCA循环管理联合曲线型仰卧护理在肿瘤压疮高风险患者中的应用效果观察

目的探讨PDCA循环管理联合曲线型仰卧护理在肿瘤压疮高风险患者中的应用效果。方法选择2022年1月—2023年6月滨州医学院附属医院收治的74例压疮高风险患者为研究对象,按随机数字表法将其分为对照组和观察组,各37例。对照组实施常规护理,观察组实施PDCA循环管理联合曲线型仰卧护理,两组均持续护理3个月。对比两组的压疮发生情况、护理舒适度及护理满意度。结果观察组压疮发生率为5.41%,低于对照组的21.62%,差异有统计学意义(P<0.05);观察组Kolcaba舒适状况量表中的心理、生理、社会文化和环境及精神评分分别为(23.70±1.73)分、(23.28±1.51)分、(23.76±1.52)分、(24.06±1.69)分,均高于对照组,组间差异有统计学意义(P<0.05);观察组护理满意度为94.59%,高于对照组的78.38%,差异有统计学意义(P<0.05)。结论PDCA循环管理联合曲线型仰卧护理在肿瘤压疮高风险患者中具有较好的应用效果,有利于减少压疮的发生,提升患者护理舒适度与满意度。

海绵翻身垫联合压疮风险量化评估护理在脑卒中后偏瘫长期卧床患者中的应用

目的探讨海绵翻身垫联合压疮风险量化评估护理干预在脑卒中后偏瘫长期卧床患者中的应用效果,以期为脑卒中后偏瘫长期卧床患者的护理干预方案制定提供参考。方法选取2020年5月—2022年7月于首都医科大学附属北京世纪坛医院就诊的110例脑卒中后偏瘫长期卧床患者,采用随机数字表法分为研究组和对照组,每组55例。对照组患者采用常规护理干预,研究组患者采用海绵翻身垫联合压疮风险量化评估护理干预。比较2组患者干预前后Braden压疮风险评估表得分及干预后压疮发生情况,采用脑卒中病损评估表(SIAS)评估2组患者干预前后的双侧肢体功能,采用舒适状况量表(GCQ)评估2组患者干预前后的舒适状况,采用脑卒中专门化生活质量量表(SS-QOL)评估2组患者干预前后的生活质量。结果研究组患者干预后的Braden评分高于对照组,差异有统计学意义(P<0.05)。研究组患者住院期间的压疮分级低于对照组,差异有统计学意义(Z=0.250,P=0.040);研究组患者住院期间压疮发生率为16.36%(9/55),低于对照组的36.36%(20/55),差异有统计学意义(χ^(2)=5.666,P=0.017)。2组患者干预前SIAS评分比较,差异无统计学意义(P>0.05);2组患者干预后SIAS评分均高于干预前,且研究组患者高于对照组,差异均有统计学意义(P<0.05)。2组患者干预前GCQ评分比较,差异无统计学意义(P>0.05);2组患者干预后GCQ评分均高于干预前,且研究组患者高于对照组,差异均有统计学意义(P<0.05)。2组患者干预前SS-QOL评分比较,差异无统计学意义(P>0.05);2组患者干预后SS-QOL评分均高于干预前,且研究组患者高于对照组,差异均有统计学意义(P<0.05)。结论海绵翻身垫联合压疮风险量化评估护理可有效降低脑卒中后偏瘫长期卧床患者的压疮发生风险,且能有效改善患者肢体功能,并提高患者的舒适度和生活质量,有利于患者的预后康复。

留痕管理法对高危压疮患者术中压疮发生率的影响

目的:探究留痕管理法对高危压疮患者术中压疮发生率的影响。方法:选取2021年1月—2022年1月焦作市妇幼保健院收治的88例高危压疮患者作为研究对象,根据随机数表法将其分为试验组和对照组,每组各44例。对照组采用常规压疮预防护理管理,试验组采用留痕管理法干预。比较两组患者管理前后认可度情况、压疮情况、并发症发生情况。结果:管理后,两组患者各项认可度评分均升高,且试验组高于对照组,差异有统计学意义(t=6.064、6.560、8.618,P<0.05);试验组压疮发生率低于对照组,差异有统计学意义(χ^(2)=4.768,P<0.05);试验组并发症发生率低于对照组,差异有统计学意义(χ^(2)=5.436,P<0.05)。结论:留痕管理法应用于高危压疮患者,可降低术中压疮发生率,提高认可度,降低并发症发生率。

步态矫正训练对老年糖尿病危险足患者足底压力的影响

目的探讨步态矫正训练对老年糖尿病危险足患者足底压力的影响。方法选取2022年9-10月在上海市2家社区卫生服务中心就诊的老年糖尿病危险足患者88例,采用抽签法将1家社区卫生服务中心的43例患者作为对照组,另1家社区卫生服务中心的45例患者作为观察组,干预过程中,观察组失访2例,对照组失访1例,最终纳入分析的患者共85例,其中对照组42例,观察组43例。对照组接受社区糖尿病健康教育及社区常规运动,观察组在对照组的基础上进行步态矫正训练,均进行为期3个月的干预。比较2组患者干预前后左、右足足底压力相关指标(峰值压力、冲量和最大力)。结果干预3个月后,观察组左、右足的峰值压力、冲量及最大力均低于对照组,差异有统计学意义(P<0.05)。结论步态矫正训练可降低老年糖尿病危险足患者左、右足的峰值压力、冲量及最大力等足底压力相关指标,改善下肢功能,预防及减少足溃疡的发生风险。

压疮风险预警护理在老年急性心肌梗死患者中的应用

目的探讨压疮风险预警护理在老年急性心肌梗死(AMI)患者中的应用。方法选取98例老年AMI患者,按照随机数字表法分为压疮风险预警组和常规组,每组49例。常规组给予常规护理干预,压疮风险预警组在常规组基础上给予压疮风险预警护理干预。干预后,比较两组压疮发生情况、家属对压疮知识掌握情况、心境状态、自我效能和生活质量。结果干预期间,压疮风险预警组压疮总发生率为8.16%,低于常规组的30.61%,差异具有统计学意义(P<0.05);干预后,压疮风险预警组家属对压疮知识掌握优良率为93.88%,高于常规组的73.74%(P<0.05);干预后,压疮风险预警组HAMD评分和HAMA评分均低于常规组,GSES评分和SF-36评分均高于常规组(P<0.05)。结论压疮风险预警护理用于老年AMI压疮患者中,可降低压疮的发生率,提升患者家属对压疮知识掌握程度,调节患者负性心境状态,提高患者自我效能感,进而提升患者的生活质量。

基于土地利用变化的六盘水市碳排放效应分析

根据2009—2018年六盘水市土地利用变化以及能源消耗数据,分析土地利用类型变化以及碳排放效应,研究其与碳排放之间的内在联系。结果表明:研究期内土地利用类型发生较大变化,其中园地、水域、建设用地呈上升态势,耕地、林地、草地、未利用地呈减少趋势。近10年净碳排放量呈增加趋势,碳汇出现下降趋势,引起六盘水市碳足迹压力指数、碳排放风险指数亦呈上升趋势。六盘水市不同时期的碳排放空间差异明显,碳排放量空间分布亦存在很大不同,六盘水市碳排放量呈现北部高的特点。碳排放量关联度不同地类不同时间在不同年份存在不同,六盘水市各区(市)建设用地和碳排放的关联度与整个六盘水市关联度比较接近,建设用地对六盘水市碳排放影响最大。

良性肿瘤手术患者发生术中急性压疮的危险因素分析

目的分析探讨良性肿瘤手术患者发生术中急性压疮的危险因素。方法选取2020年5月至2022年5月河南科技大学第一附属医院收治的202例良性肿瘤手术患者作为研究对象,收集患者性别、年龄、体重指数、基础体温、术中有无应用防压疮措施、手术持续时间、既往有无压疮史以及术后6 d内压疮(即术中急性压疮)发生情况等资料,并根据是否发生术中急性压疮将其分为急性压疮组和无急性压疮组,多因素Logistic回归分析良性肿瘤手术患者发生术中急性压疮的相关危险因素。结果202例良性肿瘤手术患者发生术中急性压疮(均为Ⅰ期)28例(13.86%),设为急性压疮组;未发生术中急性压疮174例(86.14%),设为无急性压疮组。单因素分析结果显示,急性压疮组体重指数>25.0 kg/m~2、基础体温>36.5℃、术中未应用防压疮措施、手术持续时间>180 min的患者比例均明显高于无急性压疮组(χ^(2)=110.092、6.542、7.393、76.579,P<0.001、P=0.011、P=0.007、P<0.001);多因素Logistic回归分析结果显示,体重指数>25.0 kg/m^(2)、手术持续时间>180 min是良性肿瘤手术患者发生术中急性压疮的独立危险因素(95%CI为1.137~2.569、1.332-5.871,P均<0.001)。结论良性肿瘤手术患者术中急性压疮的发生与体重指数、手术持续时间密切相关,临床应在术前对患者术中急性压疮发生情况进行风险评估,及时给予相应措施干预,以降低术中急性压疮的发生风险。

压疮风险预警护理联合全责康复护理模式在长期卧床患者中的应用效果

目的探讨压疮风险预警护理联合全责康复护理模式在长期卧床患者中的应用效果。方法选取2020年9月—2023年2月该院收治的60例长期卧床患者为研究对象,按随机数字表法将其分为对照组与观察组,各30例。对照组采用常规护理,观察组采用压疮风险预警护理联合全责康复护理模式,两组均持续护理1个月。比较两组的压疮发生率、家属压疮知识掌握度及生活质量。结果护理1个月后,观察组压疮发生率为6.67%,低于对照组的26.67%,差异有统计学意义(P<0.05)。观察组家属压疮知识掌握度为93.33%,高于对照组的70.00%,差异有统计学意义(P<0.05)。观察组健康调查简表评分高于对照组,差异有统计学意义(P<0.05)。结论压疮风险预警护理联合全责康复护理模式能有效降低长期卧床患者压疮发生率,提高家属压疮知识掌握度,改善患者生活质量。

老年患者院内难免压疮与院外带入压疮的危险营养因素分析

目的探讨老年院内难免压疮与院外带入压疮的危险营养因素的差异,提出有效防治措施。方法采集某院消化科年龄≥60岁的144例院内难免压疮(院内组)与77例院外带入压疮(院外组)老年患者的相关临床营养指标。用χ2检验,Logistic回归方法分析比较影响两组患者压疮发生的危险营养因素及差异。结果院外组老年压疮患者合并肿瘤、卧床时间≥20天、理想体重百分数<90%、小腿围<30 cm及未给予针对性营养支持者显著多于院内组(P<0.05);院内组老年压疮患者因疾病导致食欲减退、饮食类型改变及贫血者显著多于院外组(P<0.05)。Logistic回归分析结果:卧床时间长、小腿围围值减少、未给予针对性营养支持和饮食类型改变分别是导致院外组和院内组压疮发生的重要营养危险因素。结论 "人群针对性"的营养评估,应作为营养干预的基础列入压疮管理;建立出院老年卧床患者护理回访服务模式,有助于降低老年压疮发生率。

手术患者压疮危险因素评估量表的研制

目的:制定针对手术患者的压疮危险因素评估量表,使手术室压疮护理有科学的评价工具。方法:在文献回顾和专家访谈的基础上,结合临床实践经验,确立备选指标,通过专家会议法自行设计第一轮专家函询问卷,采用德尔菲法对30名专家进行3轮函询。结果:手术患者压疮危险因素评估量表一级指标有患者因素、手术因素、麻醉因素,二级指标分别包括年龄、体质指数(体重/身高2)、受压点皮肤类型、活动能力、神经感觉障碍;手术体位、手术预计时间、术中施加外力、失血量;麻醉方式等。结论:采用手术患者压疮危险因素评估量表对手术患者进行术前评估,依据量表评分采取科学、合理、具有针对性的压疮预防措施,有利于减少围手术期压疮发生率,提高手术患者生活质量。