SHEL事故分析法在ICU获得性压疮预防中的应用研究

目的采用SHEL模式分析ICU医院内获得性压疮发生的原因,以降低其发生率。方法采用SHEL模式分析ICU20例医院内获得性压疮病例并制订对策,比较采取控制措施前、后ICU压疮预防的效果。结果采取控制措施前ICU医院内获得性压疮发生率为6.25%,SHEL模式分析结果为与人员素质和能力有关(S)占30.0%,与硬件有关(H)占20.0%,与临床环境有关(E)占35.0%,与当事人及他人有关(L)占15.0%;采取控制措施后ICU医院内获得性压疮发生率为2.83%,显著低于采取措施前(P<0.05),SHEL模式分析结果为15.4%与S有关、15.4%与H有关、30.8%与E有关、38.4%与L有关。结论应用SHEL模式分析ICU医院内获得性压疮发生的原因,制定有效的措施,对降低ICU医院内获得性压疮的发生率有着积极的意义。

Effect of SHEL Model on Prevention of Hospital-Acquired Pressure Ulcer in ICU

Objective To explore the causes of hospital-acquired pressure ulcer in ICU by SHEL model, so as to reduce the incidence of hospital-acquired pressure ulcer in ICU. Methods 20 cases of hospital-acquired pressure ulcer in ICU were analyzed by SHEL model, and the measures were formulated. The effects of pressure ulcer prevention were compared before and after taking control measures. Results The incidence of hospital-acquired pressure ulcer in ICU was 6.25%;and the result of SHEL model showed that 30.0%related to soft, 20.0%related to hard, 35.0%related to environment and 15.0%related to litigant. After taking control measures, the incidence of hospital-acquired pressure ulcer in ICU was 2.83%, significantly lower than 6.25% （P〈0.05）, and SHEL model showed that 15.4% related to soft, 15.4%related to hard, 30.8%related to environment and 38.4%related to litigant. Conclusions SHEL model has positive significance in reducing the incidence of hospital-acquired pressure ulcer in ICU by cause analysis and formulation of effective measures.