压力性损伤护理评估智能决策系统的研发与应用

目的 研发压力性损伤护理评估智能决策系统,探讨其在临床压力性损伤患者中的应用效果。方法 成立研发小组,以参考预防和治疗压力性损伤：快速参考指南2019为指导蓝本,设置智能决策规则。以医院临床信息系统为基础,依托计算机信息技术,对系统的界面布局、分区、模块结构、内容和功能进行整体构架,多角度、多方位研发压力性损伤护理评估智能决策系统,实现智能决策、健康教育推送双路径、质量控制指标监测等,落实入院8 h内风险评估及时率、院内PI发生率等指标。结果 应用压力性损伤护理评估智能决策的系统后,PI入院8 h内风险评估及时率由84.7%上升至95.7%,Braden评估漏评率由8.7%下降至3.7%,Braden评估准确率由75.5%上升84.4%,创面评估准确率由77.2%上升至87.3%, 创面处理准确率由68.3%上升至79.3%,压力性损伤转归率由56.6%上升86.7%,差异均有统计学意义（P<0.05）。院内PI发生率由0.7‰降至0.3‰。结论 压力性损伤护理评估智能决策系统是一个自动化、智能化、信息化的智能决策平台,能为护理人员提供准确、客观的决策依据,能智能决策压力性损伤患者的分期,提高护理质量及管理效能。

Development and Application of Intelligent Decision System for Stress Injury Care Assessment

Objective To develop an intelligent decision system for stress injury care assessment and explore its effectiveness in pressure injury patients. Methods A research and development team was established to set up intelligent decision rules with reference to the prevention and treatment of pressure injuries: Quick Reference Guide 2019 as a guiding blueprint. Based on hospital clinical information system, and computer information technology, the overall framework of the system including interface layout, partitioning, module structure, content and functions was developed in a multi-angle and multi-directional way for intelligent decision-making, health education pushing dual pathways, quality control indicator monitoring, etc., and the implementation of indicators such as the timely rate of risk assessment within 8 hours of admission and the incidence of in-hospital PI. Results After the application of intelligent decision system for pressure injury care assessment, the timely rate of risk assessment within 8h of admission increased from 84.7% to 95.7% but the rate of missed Braden assessment decreased from 8.7% to 3.7% and the accuracy rate of Braden assessment, trauma assessment, and trauma management increased from 75.5% to 84.4%, from 77.2% to 87.3% and from 68.3% to 79.3% respectively. The transfer rate of pressure injury increased from 56.6% to 86.7%, and all the differences were statistically significant (P<0.05). The incidence of in-hospital PI decreased from 0.7 ‰ to 0.3‰. Conclusion Intelligent decision system for stress injury care assessment is automated, intelligent and information-based. It provides nurses with accurate and objective decision-making basis, which can make intelligent decisions on the staging of patients with stress injury and improve nursing quality and management effectiveness.