摘要
目的:探究基于行动研究法的皮肤和(或)组织、教育、合作、理解、报告和评价(SECURE)护理路径在重症监护室(ICU)患者医疗器械相关压力性损伤(MDRPI)预防过程中的应用效果。方法:基于行动研究法的SECURE护理路径包括成立皮肤护理小组发现问题、制定干预计划实施和开展针对性护理干预预防MDRPI发生。选取2022年3月至2023年3月河北省人民医院ICU住院治疗的84例患者,按照随机数表法将其分为对照组和观察组,每组42例,对照组患者ICU治疗期间开展常规方式预防MDRPI,观察组采用行动研究法的SECURE护理路径开展预防。对比两组患者MDRPI发生率、ICU护理质量评分、患者生活质量简表-36(SF-36)评分、MDRPI患者改善情况评估及患者护理满意度。结果:观察组患者ICU治疗期间MDRPI发生率为4.76%(2/42),低于对照组的14.29%(6/42),差异有统计学意义(χ^(2)=11.052,P<0.05);观察组患者护理干预后的设备使用、预防评估、体位管理和预防护理平均评分分别为(88.45±2.05)、(89.36±2.11)、(89.25±2.15)和(91.45±2.25)分,均高于对照组,差异有统计学意义(t=11.425、12.052、10.052、13.478,P<0.05);观察组患者护理干预后SF-36量表的躯体功能、社会功能、心理功能和物质生活平均评分分别为(85.47±2.05)、(86.48±2.05)、(88.46±2.15)和(90.25±2.44)分,均高于对照组,差异有统计学意义(t=12.414、11.045、10.252、10.478,P<0.05);观察组患者MDRPI的发生时间、创面改善时间和ICU治疗时间分别为(4.05±0.54)、(3.45±0.15)和(8.12±2.14)d,发生时间多于对照组,而创面改善时间和ICU治疗时间少于对照组,差异有统计学意义(t=8.485、10.012、13.001,P<0.05);观察组患者的护理满意度为95.24%(40/42),高于对照组的83.33%(35/42),差异有统计学意义(χ^(2)=12.054,P<0.05)。结论:基于行动研究法的SECURE护理路径对ICU患者MDRPI预防进行干预,能够降低ICU患者MDRPI发生率,提升MDRPI护理工作质量,缩短ICU治疗时间,有助于ICU患者康复。
Objective:To explore the applied effectiveness of the Skin and/or tissue,Education,Cooperation,Understanding,Report and Evaluate(SECURE)nursing pathway based on action research method in the prevention process of medical device-related pressure injuries(MDRPI)of patients in the Intensive Care Unit(ICU).Methods:The SECURE nursing pathway based on action research method included the establishment of a skin care team to identify problems,and the formulation of conducting intervention plan,and the development of targeting nursing interventions to prevent the occurrence of MDRPI.A total of 84 patients hospitalized in the ICU of Hebei General Hospital from March 2022 to March 2023 were selected,and they were randomly divided into a control group and an observation group,with 42 patients in each group.The control group implemented routine method to prevent MDRPI during ICU treatment,while the observation group implemented SECURE nursing pathway based on action research method to conduct prevention.The MDRPI incidence,the quality scores of ICU nursing,the scores of the Short Form Health Survey-36(SF-36)of patients,the assessment of the improvement of MDRPI patients,and the satisfaction of patients for nursing care were compared between the two groups.Results:The MDRPI incidence during ICU treatment in the observation group was 4.76%(2/42),which was significantly lower than that in the control group,with a statistically significant difference(χ^(2)=11.052,P<0.05).The average scores for device usage,prevention assessment,positioning management and preventive nursing after nursing intervention in the observation group were respectively(88.45±2.05),(89.36±2.11),(89.25±2.15)and(91.45±2.25),all of which were significantly higher than those in the control group,with statistically significant differences(t=11.425,12.052,10.052,13.478,P<0.05).After nursing intervention,the average scores for physical function,social function,psychological function and material life as the SF-36 scale in the observation group were(85.47±2.05),(86.48±2.05),(88.46±2.15)and(90.25±2.44),respectively,which were respectively higher than those in the control group,with statistically significant differences(t=12.414,11.045,10.252,10.478,P<0.05).The occurrence time,improvement time of wound and ICU treatment time of presenting MDRPI patients in the observation group were respectively(4.05±0.54)days,(3.45±0.15)days,and(8.12±2.14)days.Compared to the control group,the occurrence time of the observation group was longer,while both the improvement time of wound and ICU treatment time of the observation group were shorter,with statistically significant differences(t=8.485,10.012,13.001,P<0.05).The satisfaction degree of nursing care of patients in the observation group was 95.24%(40/42),which was significantly higher than that in the control group(χ^(2)=12.054,P<0.05).Conclusion:The SECURE nursing pathway based on action research method,which prevents MDRPI of ICU patients,can reduce the MDRPI incidence rate of ICU patients,and enhance the work quality of nursing care for MDRPI.It is helpful to the recovery of ICU patients,which can also shorten the treatment time of ICU patients.
作者
刘立天
赵文利
宋学莲
郑肖林
李英肖
李玉
张磊
张飞飞
Liu Litian;Zhao Wenli;Song Xuelian;Zheng Xiaolin;Li Yingxiao;Li Yu;Zhang Lei;Zhang Feifei(Department of Cardiac Intervention,Hebei General Hospital,Shijiazhuang 050057,China;Intervention Department,Henan Provincial People's Hospital,Zhengzhou 450003,China;Department of Burn and Plastic Surgery,Xingtai People's Hospital,Xingtai 054001,China;Anesthesiology Department,Hebei General Hospital,Shijiazhuang 050057,China)
出处
《中国医学装备》
2025年第1期90-95,共6页
China Medical Equipment
基金
2024年度河北省医学科学研究课题(20240220)。
关键词
行动研究法
SECURE护理路径
重症监护室(ICU)患者
医疗器械相关压力性损伤(MDRPI)
预防
Action research method
Skin and/or tissue,Education,Cooperation,Understanding,Report and Evaluate(SECURE)nursing pathway
Intensive Care Unit(ICU)patients
Medical device-related pressure injuries
Prevention
