循证护理干预方案在ICU压疮高危患者中的应用

目的探讨循证护理干预方案在ICU压疮预防中的作用。方法将227例Braden评分≤12分的压疮高危患者按照入院的顺序分为对照组102例和观察组125例。对照组采用常规护理方法。观察组进行循证护理干预，予每2h翻身1次，左右30°侧卧位交替进行；平卧位时抬高患者床头不超过30°，足跟处垫软枕；对Braden评分〈7分、颈椎骨折及病情限制翻身的患者必须使用气垫床；在受压皮肤处及可能发生压疮的皮肤区域喷赛肤润；在皮肤受压部位应用康惠尔透明贴；根据患者营养状况给予肠内外营养；保持肛周皮肤干燥。比较2组的压疮发生情况。结果观察组的压疮发生率明显低于对照组，发生时间延迟，压疮严重程度轻。结论在ICU压疮高危患者中应用循证护理干预方案，能体现护理工作的科学性和艺术性，更有效地分配有限的护理资源，减少压疮的发生。

Preventive effect of evidence-based nursing intervention program in patients at high risk of pressure ulcer in intensive care unit

Objective To explore preventive effect of evidence-based nursing intervention program in patients at high risk of pressure ulcer in intensive care unit. Methods A total of 227 patients with risk evaluation score of Braden less than 12 were randomly divided into the observation group （125 cases） and the control group （102 cases）. The control group was only given regular nursing interventions. Patients in the observation group received evidence-based nursing interventions ： including turning over per 2 hours, turning prostration to 30 degree left to tight inclined position, raising patient＇s head lower than 30 degree and putting a soft pillow under his/her heels; the patients whose risk evaluation score of Braden was less than 7, with cervical fracture or turning ever was limited by her/his situation needed to use air bed; comfeel transparent paste was used on the surface probably suffered from skin ulcer; giving PN or EN according to patients nutritional condition; keepping the skin around anus dryness. The incidence of pressure ulcer between the two groups was compared. Results The incidence rate of pressure ulcer was significantly lower in the observation group than that in the control group. The occurring time significantly delayed and the situation significantly better. Conclusions The evidence-based nursing inventions can lower the incidence rate of unavoidable pressure ulcer,reflect the scientific and artistic characteristics of nursing care, also efficient allocate limited nursing resources and reduce the incidence of pressure ulcer.