压疮的持续质量监控

目的 寻找降低压疮发生率的有效措施。方法 对质量改进前的1997～2001年带人性压疮、预报压疮、难免性压疮发生病例及质量改进后的2002年1～12月各种压疮病例进行调查分析。结果 (1)压疮发生发展与体位密切相关；(2)护士对患者潜在性的危险因素评估不准确；(3)发生压疮后的监控措施不严密。结论 降低压疮发生率，缩短带入压疮愈合时间的有效措施是：(1)控制压疮发生的关键是预防；(2)对压疮监控表的调整；(3)持续质量改进；(4)现场监控；(5)加强考核力度；(6)不间断护士长培训。

Continued Quality Control of Pressure Ulcer

Objective Pressure ulcer (PU) is a common symptom of bed-ridden patients, the prevention and treatment of which is an even bigger problem in nursing care. This study is designed to find a way to reduce the incidence of PU through investigation and analysis of factors related to the development of PU, adjustment of PU monitoring table, continued improvement of nursing quality and improvement of clinical field quality control.Methods Patients with fetch-in PU, predicting PU and hard-to-avoiding PU before quality improvement from 1997-2001 were studied retrospectively; patients with various PU after quality improvement from 2002/1-2002/12 were studied prospectively.Results The development of PU was closely related to the posture alteration of patients. Before the quality improvement,unreaching on critical value of risk factor related criterion in patients with fetch-in PU and improper evaluation of the latent PU-related factors by nurses resulted in the appearance of hard-to-avoiding PU. Inappropriate monitor and management of PU after PU happenings resulted in prolonged healing time on PU.Conclusion Effective ways to decrease the incidence of PU and shorten the healing time of PU include:1) prevention of happening of PU;2) adjustment of PU monitoring table;3) continued improvement of nursing quality; 4) field quality control of nursing services; 5) strengthening examination and evaluation on the performance of nurses;and 6) ongoing training of charge nurses.