目的:探讨风险评估结合风险分层干预措施的处方与实施压力性损伤预防干预措施的关系。
方法:单中心,横截面,观察,前瞻性。
方法:对341名成年住院患者的病理图和床边进行了检查。数据收集包括压力伤害风险水平,规定的预防性干预措施和干预措施实施的证据。
结果:大多数患者(68.6%)有压力性损伤的风险,大多数干预措施是根据其风险水平制定的。然而,来自直接观察和/或记录的证据表明干预实施率相对较差.在针对所有患者的九项干预措施中,对三种以患者/护理人员为重点的干预措施的依从性特别差,有证据表明,3%-10%的患者已经实施了这些措施。此外,营养筛查相关干预措施实施效果不佳.临床表明,对于有风险的患者,脚跟抬高装置和减肥设备的实施较低,对现有压力性损伤患者的干预措施实施效果欠佳。观察到已经实施的几项干预措施的重要比例没有记录在案。
结论:虽然大多数干预措施是根据患者的风险水平制定的,干预措施的总体执行情况较差.然而,结果可能部分是由于未能记录干预措施而不是省略干预措施。
结论:干预措施的文档至关重要,因为它提供了所提供护理的证据。需要更多地关注压力伤害预防干预措施的记录,明确区分处方和执行。
结论:结果突出了护理方面的一些不足,特别是关于执行的证据,患者参与和营养筛查。这项研究的结果将用于告知和改善研究医院内未来的压力伤害预防实践,并应用于告知和基准其他医院的压力伤害预防实践。
■该研究遵循STROBE指南。
■无。
OBJECTIVE: To explore the relationship between the prescription and implementation of pressure injury preventative interventions following risk assessment combined with a risk-stratified intervention bundle.
METHODS: Single-centre, cross-sectional, observational, prospective.
METHODS: The charts and bedsides of 341 adult inpatients were examined. Data collection included pressure injury risk level, prescribed preventative interventions and evidence of intervention implementation.
RESULTS: Most patients (68.6%) were at risk of pressure injury, and most interventions were prescribed according to their risk level. However, evidence from direct observation and/or
documentation indicated intervention implementation rates were relatively poor. Of nine interventions mandated for all patients, compliance with three patient-/carer-focused interventions was particularly poor, with evidence indicating they had been implemented for 3%-10% of patients. Also, nutritional screening-related interventions were implemented poorly. Clinically indicated implementation of heel-elevation devices and bariatric equipment was low for at-risk patients, and the implementation of interventions for patients with existing pressure injuries was suboptimal. Significant proportions of several interventions that were observed as having been implemented were not documented as such.
CONCLUSIONS: While most interventions were prescribed according to patient risk level, the overall implementation of interventions was poor. However, the results may in part be due to failure to document interventions as opposed to omitting them.
CONCLUSIONS: Documentation of interventions is crucial as it provides evidence of the care provided. An increased focus on
documentation of pressure injury preventative interventions is required, with a clear distinction between prescription and implementation.
CONCLUSIONS: The results highlighted several deficiencies in care, particularly relating to evidence of implementation, patient involvement and nutritional screening. The results from this
study will be used to inform and improve future pressure injury prevention practice within the study hospital and should be used to inform and benchmark pressure injury preventative practices in other hospitals.
UNASSIGNED: The
study adheres to STROBE guidelines.
UNASSIGNED: None.