预防脑卒中患者压疮合适翻身方案的探讨

目的 改进翻身体位和延长翻身间隔时间,探讨有效预防急性期脑卒中患者发生压疮更合适的翻身方案.方法 以常规2.0 h间隔翻身作为常规组,对急性期脑卒中患者采用不同延长翻身间隔时间(2.5,3.0,3.5 h)进行护理干预;记录患者住院期间压疮、营养状况、便秘、肺部感染等并发症的发生情况.结果 与常规护理2.0 h翻身组一样,延长翻身间隔时间的2.5 h组、3.0 h组及3.5 h组均无压疮发生.4组患者的营养状况及其他并发症的发生也无明显差异.结论 采取30°侧卧位,延长翻身间隔至2.5,3.0,3.5 h,左右侧卧位交替,均能有效预防部分急性期脑卒中患者压疮的发生.

Abstract：

Objective To observe the preventing effect of optimal programs (improving turn over postures and elongating the turn over intervals)in preventing pressure sore occurrence in patients with acute stroke. Methods Acute stage stroke patients (time from on-set less than or equal to one week)were selected and divided randomly into 4 groups, one group adopted 2.0 hours turn over intervals as the routine group, others adopted 2.5 hours, 3.0 hours, 3.5 hours turn over intervals as the study groups. The incidence of pressure sores and complications were recorded. Results None of the groups (2.0 h, 2.5 h,3.0 h, 3.5 h)suffered from pressure sores. The incidence of complications including malnutrition, pulmonary infections and constipations was not increased in the study groups either. Conclusions Optimal turn over nursing programs including elongating turn over intervals to 2.5h, 3.0h, 3.5h and adopting 30 degree lateral posture can effectively prevent occurrence of pressure sores in acute stroke patients.     

人性化管理在妇产科手术室护理管理中的应用观察研究

Objective To discuss the value of humanized management application in obstetrics and gynecology operating room nursing management. Methods 200 cases of patients admitted to the department of obstetrics and Gynecology of our hospital in the operating room as the research objective, divided into observation group, reference group by parity method, humanized management application in the observation group, routine operating room nursing management application in the reference group, compare the nursing data of the two groups. Results The rate of nurse-patient dispute in the operation room of the observation group was lower than that of the reference group, and the total incidence of complications was also lower than that of the reference group, which was significant (P＜0.05). Compared with the reference group, all nursing quality scores in the observation group were significantly higher (P＜0.05). The total nursing satisfaction in the observation group was significantly higher than that in the reference group (P＜0.05). Conclusion The application of humanized management in obstetrics and gynecology operating room nursing management, help to improve patient nursing satisfaction, and reduce the incidence of complications, reduce the incidence of nurse-patient disputes, improve the quality of nursing, improve the quality of life of patients, has clinical application value.     

压疮风险预警报告表的设计与应用研究

Objective To elevate the prevention rate and reduce the incidence of pressure ulcer inhospi-tal. Methods Design a forecast report chart to assess patients who were in hospital from Jan. 2007 to Dec. 2008 by putting this chart in application, from which screen out 1881 patients who were susceptible to high risk of pressure ulcer (patients" risk scale was below 14) . Those patients were regarded as investigation group, and their shin con-difions was observed, and taken effective nursing measures. Using historical contrast, the patients picked out by Braden chart in Jan. 2005-Dec. 2006 were considered as control group. The differences in gender, age, history, and the number of patients between two groups were insignificant (P>0.05) . The high - risk prediction accura-cy rate of pressure ulcer, inevitable pressure ulcer rate, the amount of inevitable pressure ulcer in different depth, and the amount of evitable pressure ulcer were analyzed. Results The high - risk prediction accuracy rote of pres-sure ulcer, inevitable pressure ulcer rate, the amount of inevitable pressure ulcer in Ⅱ depth, and the amount of evitable pressure ulcer inhospital of investigation group were significantly better than those of control group (P < 0.05) . Conclusions The forecast report chart is a more effective in pressure ulcer risk prediction. Predictive nuring , management and supervision for patients with pressure ulcer high risk factors are conducive to the im-provement of the basic nursing quality and thus lower the incidence of pressure ulcer among high risk patients.     

压疮风险预警报告表的设计与应用研究

Objective To elevate the prevention rate and reduce the incidence of pressure ulcer inhospi-tal. Methods Design a forecast report chart to assess patients who were in hospital from Jan. 2007 to Dec. 2008 by putting this chart in application, from which screen out 1881 patients who were susceptible to high risk of pressure ulcer (patients" risk scale was below 14) . Those patients were regarded as investigation group, and their shin con-difions was observed, and taken effective nursing measures. Using historical contrast, the patients picked out by Braden chart in Jan. 2005-Dec. 2006 were considered as control group. The differences in gender, age, history, and the number of patients between two groups were insignificant (P>0.05) . The high - risk prediction accura-cy rate of pressure ulcer, inevitable pressure ulcer rate, the amount of inevitable pressure ulcer in different depth, and the amount of evitable pressure ulcer were analyzed. Results The high - risk prediction accuracy rote of pres-sure ulcer, inevitable pressure ulcer rate, the amount of inevitable pressure ulcer in Ⅱ depth, and the amount of evitable pressure ulcer inhospital of investigation group were significantly better than those of control group (P < 0.05) . Conclusions The forecast report chart is a more effective in pressure ulcer risk prediction. Predictive nuring , management and supervision for patients with pressure ulcer high risk factors are conducive to the im-provement of the basic nursing quality and thus lower the incidence of pressure ulcer among high risk patients.     

压疮风险预警报告表的设计与应用研究

Objective To elevate the prevention rate and reduce the incidence of pressure ulcer inhospi-tal. Methods Design a forecast report chart to assess patients who were in hospital from Jan. 2007 to Dec. 2008 by putting this chart in application, from which screen out 1881 patients who were susceptible to high risk of pressure ulcer (patients" risk scale was below 14) . Those patients were regarded as investigation group, and their shin con-difions was observed, and taken effective nursing measures. Using historical contrast, the patients picked out by Braden chart in Jan. 2005-Dec. 2006 were considered as control group. The differences in gender, age, history, and the number of patients between two groups were insignificant (P>0.05) . The high - risk prediction accura-cy rate of pressure ulcer, inevitable pressure ulcer rate, the amount of inevitable pressure ulcer in different depth, and the amount of evitable pressure ulcer were analyzed. Results The high - risk prediction accuracy rote of pres-sure ulcer, inevitable pressure ulcer rate, the amount of inevitable pressure ulcer in Ⅱ depth, and the amount of evitable pressure ulcer inhospital of investigation group were significantly better than those of control group (P < 0.05) . Conclusions The forecast report chart is a more effective in pressure ulcer risk prediction. Predictive nuring , management and supervision for patients with pressure ulcer high risk factors are conducive to the im-provement of the basic nursing quality and thus lower the incidence of pressure ulcer among high risk patients.     

压疮风险预警报告表的设计与应用研究

Objective To elevate the prevention rate and reduce the incidence of pressure ulcer inhospi-tal. Methods Design a forecast report chart to assess patients who were in hospital from Jan. 2007 to Dec. 2008 by putting this chart in application, from which screen out 1881 patients who were susceptible to high risk of pressure ulcer (patients" risk scale was below 14) . Those patients were regarded as investigation group, and their shin con-difions was observed, and taken effective nursing measures. Using historical contrast, the patients picked out by Braden chart in Jan. 2005-Dec. 2006 were considered as control group. The differences in gender, age, history, and the number of patients between two groups were insignificant (P>0.05) . The high - risk prediction accura-cy rate of pressure ulcer, inevitable pressure ulcer rate, the amount of inevitable pressure ulcer in different depth, and the amount of evitable pressure ulcer were analyzed. Results The high - risk prediction accuracy rote of pres-sure ulcer, inevitable pressure ulcer rate, the amount of inevitable pressure ulcer in Ⅱ depth, and the amount of evitable pressure ulcer inhospital of investigation group were significantly better than those of control group (P < 0.05) . Conclusions The forecast report chart is a more effective in pressure ulcer risk prediction. Predictive nuring , management and supervision for patients with pressure ulcer high risk factors are conducive to the im-provement of the basic nursing quality and thus lower the incidence of pressure ulcer among high risk patients.     

压疮风险预警报告表的设计与应用研究

Objective To elevate the prevention rate and reduce the incidence of pressure ulcer inhospi-tal. Methods Design a forecast report chart to assess patients who were in hospital from Jan. 2007 to Dec. 2008 by putting this chart in application, from which screen out 1881 patients who were susceptible to high risk of pressure ulcer (patients" risk scale was below 14) . Those patients were regarded as investigation group, and their shin con-difions was observed, and taken effective nursing measures. Using historical contrast, the patients picked out by Braden chart in Jan. 2005-Dec. 2006 were considered as control group. The differences in gender, age, history, and the number of patients between two groups were insignificant (P>0.05) . The high - risk prediction accura-cy rate of pressure ulcer, inevitable pressure ulcer rate, the amount of inevitable pressure ulcer in different depth, and the amount of evitable pressure ulcer were analyzed. Results The high - risk prediction accuracy rote of pres-sure ulcer, inevitable pressure ulcer rate, the amount of inevitable pressure ulcer in Ⅱ depth, and the amount of evitable pressure ulcer inhospital of investigation group were significantly better than those of control group (P < 0.05) . Conclusions The forecast report chart is a more effective in pressure ulcer risk prediction. Predictive nuring , management and supervision for patients with pressure ulcer high risk factors are conducive to the im-provement of the basic nursing quality and thus lower the incidence of pressure ulcer among high risk patients.     

压疮风险预警报告表的设计与应用研究

Objective To elevate the prevention rate and reduce the incidence of pressure ulcer inhospi-tal. Methods Design a forecast report chart to assess patients who were in hospital from Jan. 2007 to Dec. 2008 by putting this chart in application, from which screen out 1881 patients who were susceptible to high risk of pressure ulcer (patients" risk scale was below 14) . Those patients were regarded as investigation group, and their shin con-difions was observed, and taken effective nursing measures. Using historical contrast, the patients picked out by Braden chart in Jan. 2005-Dec. 2006 were considered as control group. The differences in gender, age, history, and the number of patients between two groups were insignificant (P>0.05) . The high - risk prediction accura-cy rate of pressure ulcer, inevitable pressure ulcer rate, the amount of inevitable pressure ulcer in different depth, and the amount of evitable pressure ulcer were analyzed. Results The high - risk prediction accuracy rote of pres-sure ulcer, inevitable pressure ulcer rate, the amount of inevitable pressure ulcer in Ⅱ depth, and the amount of evitable pressure ulcer inhospital of investigation group were significantly better than those of control group (P < 0.05) . Conclusions The forecast report chart is a more effective in pressure ulcer risk prediction. Predictive nuring , management and supervision for patients with pressure ulcer high risk factors are conducive to the im-provement of the basic nursing quality and thus lower the incidence of pressure ulcer among high risk patients.     

压疮风险预警报告表的设计与应用研究

Objective To elevate the prevention rate and reduce the incidence of pressure ulcer inhospi-tal. Methods Design a forecast report chart to assess patients who were in hospital from Jan. 2007 to Dec. 2008 by putting this chart in application, from which screen out 1881 patients who were susceptible to high risk of pressure ulcer (patients" risk scale was below 14) . Those patients were regarded as investigation group, and their shin con-difions was observed, and taken effective nursing measures. Using historical contrast, the patients picked out by Braden chart in Jan. 2005-Dec. 2006 were considered as control group. The differences in gender, age, history, and the number of patients between two groups were insignificant (P>0.05) . The high - risk prediction accura-cy rate of pressure ulcer, inevitable pressure ulcer rate, the amount of inevitable pressure ulcer in different depth, and the amount of evitable pressure ulcer were analyzed. Results The high - risk prediction accuracy rote of pres-sure ulcer, inevitable pressure ulcer rate, the amount of inevitable pressure ulcer in Ⅱ depth, and the amount of evitable pressure ulcer inhospital of investigation group were significantly better than those of control group (P < 0.05) . Conclusions The forecast report chart is a more effective in pressure ulcer risk prediction. Predictive nuring , management and supervision for patients with pressure ulcer high risk factors are conducive to the im-provement of the basic nursing quality and thus lower the incidence of pressure ulcer among high risk patients.     

压疮风险预警报告表的设计与应用研究

Objective To elevate the prevention rate and reduce the incidence of pressure ulcer inhospi-tal. Methods Design a forecast report chart to assess patients who were in hospital from Jan. 2007 to Dec. 2008 by putting this chart in application, from which screen out 1881 patients who were susceptible to high risk of pressure ulcer (patients" risk scale was below 14) . Those patients were regarded as investigation group, and their shin con-difions was observed, and taken effective nursing measures. Using historical contrast, the patients picked out by Braden chart in Jan. 2005-Dec. 2006 were considered as control group. The differences in gender, age, history, and the number of patients between two groups were insignificant (P>0.05) . The high - risk prediction accura-cy rate of pressure ulcer, inevitable pressure ulcer rate, the amount of inevitable pressure ulcer in different depth, and the amount of evitable pressure ulcer were analyzed. Results The high - risk prediction accuracy rote of pres-sure ulcer, inevitable pressure ulcer rate, the amount of inevitable pressure ulcer in Ⅱ depth, and the amount of evitable pressure ulcer inhospital of investigation group were significantly better than those of control group (P < 0.05) . Conclusions The forecast report chart is a more effective in pressure ulcer risk prediction. Predictive nuring , management and supervision for patients with pressure ulcer high risk factors are conducive to the im-provement of the basic nursing quality and thus lower the incidence of pressure ulcer among high risk patients.     

分级分期管理对压疮预防和治疗的研究

目的 探讨分级分期管理在压疮临床护理中的作用.方法 选择住院的压疮高危人群402例,随机分为干预组(202例)与对照组(200例),干预组进行临床护理压疮护理知识培训、成立二级压疮委员会、及时填写皮肤压疮危险度评分表和上报报告、分级分期进行护理,对照组采取常规护理方法,即对压疮高危人群进行翻身、按摩、治疗等方法,分析干预组与对照组压疮发生率.结果 对照组压疮发生率为2.3%,二三期发生率为1.5%;干预组压疮发生率为1.2%,二三期发生率为0.4%,两组差异有统计学意义(P＜0.05).结论 在压疮的临床护理中,进行分级分期管理对压疮的发生率有明显的降低,转归有显著的效果.     

主要照顾者压疮类现场管理平台在高龄压疮高危患者中的应用

目的 观察主要照顾者压疮类现场管理平台在高龄压疮高危患者中的应用效果。 方法选择主要照顾者压疮类现场管理平台应用前(2016年7-12月)和应用后(2017年1-6月)于我院出院并诊断为高龄压疮的高危患者作为研究对象,分别设为对照组与观察组各40例。对照组接受常规护理,观察组在此基础上加用主要照顾者压疮类现场管理平台干预,比较2组压疮发生率及主要照顾者压疮知识和压疮照顾行为。 结果 出院6个月时,观察组照顾者的压疮知识与压疮照顾行为评分均显著高于对照组(t=10.240,P<0.001; t=10.513,P<0.001),观察组出院后6个月内压疮发生率低于对照组(χ²=4.507,P=0.034)。 结论 采用压疮类现场管理平台对高龄压疮高危患者的照顾者施加干预,可显著提高照顾者压疮知识水平与压疮照顾行为能力,降低压疮的发生率。     

美皮康敷料治疗老年患者一、二期压疮疗效观察

目的观察美皮康敷料治疗老年患者一、二期压疮的效果。方法对2010年发生一、二期压疮的123例老年患者随机分为对照组和观察组。对照组使用传统的压疮治疗方法,观察组应用美皮康敷料治疗,比较两组患者压疮治疗有效率和压疮治愈时间。结果观察组压疮治疗有效率（98．28％）高于对照组（84．62％）,且观察组患者一期压疮治愈时间较对照组缩短,差异有统计学意义（P〈0．05）。结论美皮康敷料能显著提高老年患者一、二期压疮治疗效果。     

樟树皮粉联合TDP治疗Ⅱ、Ⅲ期压疮的疗效观察

目的:观察樟树皮粉外敷联合TDP对Ⅱ、Ⅲ期压疮的疗效,探索一种对压疮治愈率高、疗程短且经济有效的药物治疗方法。方法:选择2010年1月～2011年6月在我院综合ICU住院的卧床并出现Ⅱ、Ⅲ期压疮的患者88例,共110处压疮。将患者随机分为两组,治疗组(A组)在压疮护理常规基础上采用TDP治疗仪治疗压疮创面20 min后予灭菌樟树皮粉外敷治疗;对照组(B组)则在压疮护理常规基础上采用美宝湿润烧伤膏外敷。治疗10 d后,观察两组压疮创面的大小、深度、色泽、表面有无结痂、渗出、脓腐及肉芽组织生长情况。结果:治疗组的总有效率为98.24%明显优于对照组的62.26%,两组比较有统计学意义(P<0.01)。结论:樟树皮粉联合TDP治疗Ⅱ、Ⅲ期压疮疗效显著,可缩短压疮创面愈合时间,且取材方便,价格低廉,值得推广。     

The surveillance system of decubital lesions of the University Polyclinic in Udine: results of an incidence study

A retrospective study of the incidence of pressure sores was one of the principal component of the ad hoc program of surveillance, prevention and treatment of pressure sores started in 1996 at University Hospital of Udine. Data were collected from the nursing records of patients defined at risk according to the Waterlow scale and admitted during 1998-99. Aims of the study were to quantify the number of patients who developed a pressure sore while in hospital and their risk level; stage of the lesions; to qualify the main risk factors and the management strategies adopted (i.e. mattresses, medications). Overall, 151 subjects (20.7% of those recruited) developed a pressure sore the greatest majority (96%) were classified as transient and reactive redness or superficial sore, while 14 patients (4%) developed a severe sore. For 50.4% of the lesions a regression to a lower risk level or healing were documented.     

三联药液治疗压疮的疗效观察

目的：探讨万花油、利福平、头孢氨苄三联药液治疗压疮的疗效。方法：选择Ⅱ～Ⅲ期压疮患者30例,随机分为观察组和对照组各15例。观察组采用万花油、利福平、头孢氨苄三联药液治疗,对照组采用常规方法治疗。结果：三联药液对治疗Ⅱ期压疮效果显著,对Ⅲ期有一定疗效,并加快了压疮的愈合。结论：三联药液具有抗炎消肿,促进创面愈合的作用,治疗压疮的效果优于常规方法。     

Braden压疮风险护理记录单在卧床患者中的应用

目的:探讨Braden压疮风险护理记录单在卧床患者中的应用效果。方法:将2009年1月～2010年1月本科收治的卧床患者50例作为对照组,将2010年2月～2011年2月50例卧床患者作为试验组,对照组采用常规的防压疮护理,试验组采用Braden压疮风险护理记录单对卧床患者评估评分后实施防压疮护理,比较两组患者的压疮发生率。结果:试验组患者压疮发生率明显低于对照组(P<0.05)。结论:Braden压疮风险护理记录单的使用能有效降低卧床患者压疮的发生率,保障卧床患者的皮肤安全。     

Assessment and evaluation of pressure sores

Pressure sore prevention is the desired goal to maintain skin integrity. It is a challenging nursing responsibility. The process of pressure sore prevention requires skilled nursing assessment of the integumentary system and knowledge of risk factors, as well as an ongoing evaluation plan to monitor incidence and the efficacy of nursing care. Pressure sore assessment is greatly aided by the availability of several research-based instruments. Assessment instruments grounded in research are rather unique because few nursing problems, other than pressure sores, have such instruments available. Further testing of the predictive validity of risk factors is needed even though instruments have already proved valuable in delineating high-risk patients. Well-designed programs of process and outcome evaluation can result in lower incidence rates and reduced severity of pressure sores. Assessment and evaluation are essential to quality nursing care.     

压疮高危病人护理质量的全程控制

目的探讨压疮高危病人的护理质量控制方法，提高护理质量，降低压疮发生率。方法2006年1月成立匿疮管理指导小组，对预报高危的病人进行床边核查，每月随机榆查在院的离危病人护理质量，运用质量持续改进流程纠正护理中的不足，对发生压疮的病人进行跟踪观察，指导、会诊等。结果537例预报高危的病人中37例发生压疮，发生率为6．9％，低于同类报道；高危病人护理质量均合格。护理人员熟练掌握评估工具的使用。结论对压疮高危病人护理质量进行全程控制，能提高卧床病人的基础护理质量，促进护士列压疮的预防知识和技术的掌握与应用，保证预防措施落实到垃，降低高危病人压疮发生率。     

分级监控管理对预防重症脑外伤患儿术后压疮的影响

目的：探讨分级监控管理对预防重症脑外伤患儿术后压疮的影响。方法选取2013年1月至2014年12月收治的84例重症脑外伤患儿为研究对象,根据患儿入院时间分为观察组(2014年1~12月)和对照组(2013年1~12月)各42例,对照组给予常规性护理,观察组给予分级监控管理,对比分析两组患儿护理质量、压疮风险评估率、压疮发生率、护理纠纷投诉率及家属满意率情况。结果观察组基础护理、专科护理、危重患儿护理、护理记录、病房管理、急救药品和器械以及总护理质量评分显著高于对照组( P<0.05)。观察组压疮发生率、护理纠纷投诉率低于对照组(P<0.05),压疮风险评估率、家属满意率高于对照组(P<0.05)。结论分级监控管理能有效提高重症脑外伤患儿护理质量,提高压疮风险评估率,从而降低患儿压疮发生率,降低护患纠纷事件发生率,提高患儿家属满意率。