理疗充气床垫辅以换床单在预防压疮中的临床应用

目的：探讨理疗充气床垫辅以换床单在压疮预防中的作用。方法：将800例压疮高危患者随机分为常规床单位组（A组：405例）、理疗充气床垫辅以换床床单组（B组：395例）,分别对两组进行护理,观察患者皮肤变化并记录压疮发生情况,通过纽卡斯尔护理服务满意度量表评价患者对护士的护理服务满意度。结果：A组压疮发生率为6.42%,B组压疮发生率为3.54%,B组压疮发生率明显低于A组（x2=4.22,P〈0.05）;患者对护士的护理服务满意度显著提高（t=6.845,P〈0.01）。结论：理疗充气床垫辅以换床床单模式既可节约人力,又可以减少危重患者压疮的发生,提高患者对护理的满意度,具有临床推广价值。     

外科手术中皮肤压疮的预防与护理

目的总结外科手术中皮肤压疮的预防及护理措施,防止发生压疮。方法分析手术患者发生压疮的原因并采取相应的护理措施。结果 1例患者尾骶部出现水泡;1例患者左足跟部出现水泡;1例皮肤发红,经处理未发生皮肤破溃。结论通过对手术过程中压疮的发生机制和原因分析,制定保护性护理措施,可以有效预防压疮的发生,提高手术室护理质量。     

压疮的预防与护理

目的通过了解压疮发生的原因及诱因,易发人群,总结压疮的防治方法,减少压疮发生率,减轻患者痛苦。提高护理质量。方法阅读大量相关资料,联系临床实践,吸取先进经验。结果压疮的发生与患者年龄、营养状况及所患疾病,局部皮肤清洁及创口处理,医疗环境舒适程度,护理质量有很大关系,提高护理人员的责任心。结论压疮的护理应以预防为主,治疗为辅,未病先防,已病防止恶化,忌单一护理局部压疮,忌单一护理方法。     

皮肤预检和告知在压疮防治上的探讨

目的:探讨对高危皮肤患者实施院前评估、告知及相关的健康教育方法的管理.方法:根据目前医院压疮风险管理流程,对皮肤风险实施院前评估,并将评分内容、压疮危害与护理措施详细告知患者及家属,同时落实三级监控.结果:患者及家属深刻了解发生压疮的危害,患者积极配合、家属主动参与,申报的难免压疮117例患者,仅发生压疮8例,6例经综合处理后痊愈出院.结论:落实患者院前皮肤评估、护理告知,增进了院内压疮防治信息的流通,缩短了院外带入压疮的治疗时间,最大限度降低了院内压疮发生率.     

海绵床与气垫床对危重患者预防压疮效果比较

目的比较海绵床与气垫床对危重患者预防压疮的临床效果。方法选取48例2009年10月-2010年3月我院收治的危重患者且需长期卧床病例,按随机原则予以海绵床垫(厚15cm)24例,标为实验组;予以气垫床24例,标为对照组。两组患者均采取同时间翻身,观察患者受压皮肤湿度、压疮出现比例及并发症的情况。结果通过对皮肤湿度及压疮出现比例等情况分析,得出实验组临床效果明显优越于对照组,且差异具有统计学意义(P<0.05)。结论相对于气垫床,采用海绵床(厚15cm)护理危重患者预防压疮的效果明显,值得临床大力推广使用。     

54例低蛋白血症患者围压疮期皮肤护理

目的：了解低蛋白血症患者围压疮期皮肤的护理方法及措施，减少低蛋白血症患者压疮的发生率。方法：对54例低蛋白血症患者实施辨证评估，同患者及其家属进行沟通，正确处理压疮前卧位与姿势、便盘的使用,压疮发生后的处理、科学的饮食护理、针对性的心理护理。结果：54例低蛋白血症患者发生压疮的患者3例，未发生医患纠纷。结论：低蛋白血症患者通过护理评估、饮食护理、压疮前护理措施可降低压疮发生率，通过医患沟通发生压疮后可避免医患纠纷。     

细节管理在心内科护理管理中的应用

目的通过临床病例资料分析探讨细节管理在心内科临床护理工作中的应用效果,提高临床护理质量。方法随机选取该院2013年1月~12月期间心内科收治住院的患者各80例作为该组研究的观察组和对照组,对照组只给予常规护理管理,观察组在常规护理管理的基础给予细节管理,通过对比两组患者的不良事件发生情况与护理管理效果得出结论。结果①观察组的压疮、管道护理不当及跌倒坠床发生率分别为7.5%(6/80)、11.25%(9/80)及6.25%(5/80),对照组压疮、管道护理不当及跌倒的发生率分别为23.75%(19/80)、21.25%(17/80)及11.25%(9/80),观察组均明显低于对照组,差异有统计学意义(P<0.05)。②观察组发生压疮6例,均为一期压疮;对照组发生压疮19例,其中一期压疮12例,二期压疮7例;观察组发生管道护理不当9例,其中标识不完整3例、敷料松脱2例、管道移位1例、记录不全面3例;对照组发生管道护理不当9例,其中标识不完整7例、敷料松脱4例、管道移位3例、记录不全面3例;观察组发生跌倒4例、坠床1例;对照组发生跌倒6例、坠床3例;除管道记录不全面外,观察组各项指标都显著高于对照组,差异有统计学意义(P<0.05)。结论在心内科护理工作中开展细节管理,可以有效减少压疮、管道护理不当及跌倒等不良事件的发生,避免由于护理疏忽对患者造成的损伤,明显提高护理质量。     

四级一体式皮肤管理模式在ICU危重患者中的应用

目的：探索ICU危重患者皮肤的有效管理方法。方法：在医院-科室层面组建四级一体式皮肤质控小组。结果：ICU护士对压疮相关知识的掌握程度提高,科内各种压疮有效上报率明显增加,难免压疮及非高危皮肤压疮发生率下降。结论：在医院-科室层面组建四级一体式皮肤质控小组对压疮的管理效果良好,压疮发生率降低。     

临床患者引起压疮的原因、预防及治疗

通过总结压疮发生的原因及诱因、易发人群,总结压疮的预防及护理方法,减少压疮发生率,减轻患者痛苦。压疮的发生与患者年龄、营养状况、所患疾病、局部皮肤清洁及创口处理、医疗环境舒适程度、护理质量有着极大的关系。     

护理部对压疮护理过程的监控与管理探讨

目的:对压疮护理工作进行专门的管理与监控,降低出现压疮症状的概率。方法:选取我院过去四年出现的难免压疮患者30例,带入压疮患者87例,预报压疮146例,收集患者有关资料,为其提供专门的管理与监控,观察带入压疮与难免压疮好转率与发生率。结果:护理人员预防压疮的意识提高,难免压疮出现例数明显降低。结论:对压疮护理工作进行专门的管理与监控,有效加快了患者的康复速度,护理效果良好,临床价值值得推广。     

A literature review of different pressure ulcer models from 1942–2005 and the development of an ideal animal model

The literature from 1942-2005 was reviewed in order to determine an inexpensive animal model which can closely mimic pressure ulcers seen in humans of varying ages, without the need for surgical procedures. Two animal models for producing pressure ulcers were found to be inexpensive: pigs to mimic pressure ulcers in young humans due to their fixed skin, and rats to mimic pressure ulcers in the elderly due to their loose skin. The methods which were found to be inexpensive, reproducible, non-invasive and easy to carry out without the need of a surgeon or specialist were the use of magnets for rat models and the use of a cast placed over a bony prominence for pig models.     

Elimination of a pressure ulcer with electrical stimulation--a case study

Pressure ulcers, also called decubitus ulcers, are a common challenge of humanity and are exceptionally difficult to heal. They are wounds that are initiated by relatively short periods of pressure on the skin that blocks blood circulation causing the skin and underlying tissues to die, leading to an open wound. Pressure release can prevent further tissue degeneration, and some ulcers heal and disappear by themselves. However, many pressure ulcers never heal and continue to grow in diameter and depth. By one year, such unhealing ulcers are referred to as chronic ulcers. Chronic ulcers frequently jeopardize the life of the patient due to infections that become increasingly deep until they invade bones and the circulatory system. We report on a patient with a chronic pressure ulcer at his coccyx prominence. Fourteen months after the ulcer had appeared, a surface pulse electromagnetic force (PEMF) stimulator was applied over T7-T8, 45 cm cephalic to the ulcer, as part of a nerve stimulation study. Although the ulcer had continued to grow both in diameter and depth for 14 months and showed no signs of healing, within 6 days of applying the PEMF stimulator, the ulcer began to heal and was fully eliminated after 3 months. We concluded that the electrical stimulation induced the healing of the pressure ulcer. The ulcer elimination is quite surprising due to the exceptionally low electric field-force being generated by the stimulator at a distance of 45 cm.     

Prelude to death or practice failure? Trombley-brennan terminal tissue injuries

A group of palliative care nurses wanted to investigate the phenomenon they were witnessing in their end-of-life patients. There was a rapid onset of skin change characterized by bruising on various parts of the body in these patients. Traditionally they were described as pressure ulcers. However, the skin changes did not progress as typical pressure ulcers and warranted more investigation.     

浅谈压疮的预防与护理

压疮是由于身体的局部组织长期受压,或局部皮肤长期摩擦、受潮湿刺激,及全身营养不良、水肿,使局部组织缺血、缺氧、营养不良、血液循环障碍,而致局部皮肤和皮下组织红、肿、热、痛、溃烂、坏死。好发于卧床患者的骨突出部位,如臀部、髋部、骶尾部、耳廓、枕骨结节及肩胛部和足跟等处,其中以髋部和骶尾部最多见。现将压疮的预防和护理体会介绍如下。     

The effects of traditional and computer-aided instruction on promoting independent skin care in adults with paraplegia

This study aimed to explore the viability of using computer-aided instruction (CAI) as an educational tool for promoting independent skin care in adults with paraplegia. There is a need to identify effective intervention strategies that provide health education for skin care management and the prevention of pressure ulcers for individuals with spinal cord injuries (SCI). There continues to be tremendous financial and personal costs associated with the treatment of pressure ulcers and the prevalence of skin breakdown among the SCI population, despite traditional educational methods. The methodology used in this study evaluated to what degree CAI assisted individuals with paraplegia to acquire knowledge and demonstrate skills necessary for optimal skin care. Results were obtained using a multiple baseline across subjects approach including an ABC (for two subjects) and an AC (for one subject) single case experimental design. Results indicated that CAI was more effective than traditional educational methods in increasing the initiation and performance of pressure-relieving techniques. Limitations in this study include the possibility of carryover effects, relatively short time periods for baseline and treatment conditions, and extraneous variables that were difficult to control such as the participants' level of motivation and cooperation. Further study using a larger group design with a control group is recommended to explore the effects CAI has on promoting optimal skin care among adults with paraplegia.     

综合性医院入院患者合并压疮的相关因素研究分析

目的：探索综合性医院入院合并压疮的患者,其发生压疮的相关因素。方法：使用统一的压疮评估方法、压疮上报流程,对某医院2009~2012年入院患者合并压疮上报资料进行分项描述性统计分析,统计其发生率。结果：入院患者合并压疮患病率为0.611%。常见于慢性阻塞性肺炎、脑血管疾病、肿瘤晚期等患者。最常见部位是骶尾部。结论：≥60岁的入院患者是合并压疮的主要人群;骶尾部、股骨粗隆、足跟部是压疮主要发生部位;呼吸中医科、急诊内科、神经内科等科室是压疮高发科室。     

美皮康在压疮防治中的临床效果观察

目的观察美皮康在压疮防治过程中的临床效果。方法对2008年12月～2010年1月入住笔者所在科室的45例压疮高危患者根据不同分期采用美皮康进行针对性的护理,并判断其疗效。结果．32例患者的皮肤问题得以治愈,治愈率达71％,有效率达98％。结论采用美皮康对压疮高危患者进行精心科学的护理,取得了满意的效果。     

Infected pressure ulcers in the long-term-care facility.

Pressure ulcers occur with some frequency in the elderly, debilitated population in long-term-care facilities. Pressure ulcers cause morbidity and mortality and, by virtue of breaking the integumentary barrier, predispose to skin and soft-tissue infections. The latter often are deep and require lengthy medical and surgical therapy. Prevention depends on avoidance of pressure, as well as providing adequate nutrition and meticulous skin care.     

Prevention and treatment of pressure ulcers

Pressure ulcers are complex chronic wounds for which no gold standard for prevention or treatment has yet been established. Several attempts at developing guidelines has been undertaken by different organizations. Pressure ulcers are devastating comorbidities for patients and difficult to prevent or manage. Whether or not pressure ulcers are preventable remains controversial. The strategy for prevention includes recognizing the risk, decreasing the effects of pressure, assessing nutritional status, avoiding excessive bed rest and prolonged sitting, and preserving the integrity of the skin. The principles of treatment of pressure ulcers include assessing severity, reducing pressure, friction and shear forces, optimizing local wound care, removing necrotic debris, managing bacterial contamination, and correcting nutritional deficits.