ICU医疗器械相关性压力性损伤闭环管理系统的构建及应用

doi:10.3761/j.issn.0254-1769.2021.04.011

摘要/Abstract

摘要：

目的构建ICU医疗器械相关性压力性损伤（medical device-related pressure injuries,MDRPI）闭环管理系统,探讨其在临床中的应用效果。方法构建由风险评估、临床护理决策、质量与安全管理模块组成的ICU MDRPI闭环管理系统,于2019年7月在广东省某三级甲等医院ICU病房中使用,比较闭环管理系统应用前后6个月患者入ICU时MDRPI评估率、MDRPI住院评估率、MDRPI高风险患者筛查率、临床护理决策实施率、MDRPI发生率。结果闭环管理系统应用后,患者入ICU时MDRPI评估率从64.3%上升至96.8%,MDRPI住院评估率从44.9%上升至98.2%,MDRPI高风险患者筛查率从51.3%上升至98.9%,临床护理决策实施率从39.6%上升至95.8%,MDRPI发生率从15.9%下降至7.3%,差异均具有统计学意义﹙P<0.001﹚。结论 ICU MDRPI闭环管理系统能帮助ICU护士科学、客观地评估MDRPI,并作出合理的护理决策,可规范MDRPI管理流程,有效降低MDRPI发生率。

关键词: 重症监护病房, 医疗器械相关性压力性损伤, 护理信息学, 护理管理研究

Abstract:

Objective A closed-loop management system for ICU medical device-related pressure injuries（MDRPI）was developed,so as to explore the effects of its application in clinical management. Methods The closed-loop management system of ICU MDRPI was constructed and it was composed of risk assessment,clinical nursing decision-making,quality and safety management. It is convenient to extract critically ill patients from ICU wards of a tertiary hospital in Guangdong province. The data before and after the implementation of the closed-loop management system for 6 months was compared,including the assessment rate of MDRPI in ICU,the assessment rate of MDRPI hospitalization,the screening rate of high-risk patients,the implementation rate of clinical nursing decision-making,and the incidence rate of MDRPI in ICU. Results Before and after the implementation of the closed-loop management system,the evaluation rate of MDRPI of ICU patients increased from 64.3% to 96.8%;the evaluation rate of MDRPI hospitalization increased from 44.9% to 98.2%;the screening rate of high-risk MDRPI patients increased from 51.3% to 98.9%;the implementation rate of clinical nursing decision increased from 39.6% to 95.8%;the incidence rate of MDRPI in ICU decreased from 15.9% to 7.3%. The differences were statistically significant（P<0.001）. Conclusion The construction and application of ICU MDRPI closed-loop management system can help ICU nurses scientifically and objectively evaluate and make decisions on MDRPI nursing programs,standardize ICU MDRPI management process,and effectively reduce the incidence of ICU MDRPI.

Key words: Intensive Care Units, Medical Device-Related Pressure Injuries, Nursing Informatics, Nursing Administration Research

黄庆萍,张建荣,农礼荣,杨凤玲,张淑清,许柳琴,宁琴荣,吴庆梅. ICU医疗器械相关性压力性损伤闭环管理系统的构建及应用[J]. 中华护理杂志, 2021, 56(4): 545-549.

HUANG Qingping,ZHANG Jianrong,NONG Lirong,YANG Fengling,ZHANG Shuqing,XU Liuqin,NING Qinrong,WU Qingmei. Construction and application of closed loop management system for medical device-related pressure injuries in ICU[J]. Chinese Journal of Nursing, 2021, 56(4): 545-549.

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