Braden单项评分管理对降低院内压力性损伤的预警研究

冯春; 王婧楠; 陈萍

doi:10.16766/j.cnki.issn.1674-4152.002617

Braden单项评分管理对降低院内压力性损伤的预警研究

doi: 10.16766/j.cnki.issn.1674-4152.002617

中国科学院大学宁波华美医院护理部，浙江宁波 315010

基金项目:

浙江省医药卫生健康科技计划项目 2022KY1131

中国科学院大学宁波华美医院研究基金项目 2021HMKY24

详细信息

通讯作者:
陈萍, E-mail: 1256940265@qq.com

中图分类号: R471 R632.1
计量
- 文章访问数: 409
- HTML全文浏览量: 204
- PDF下载量: 3
- 被引次数: 0
出版历程
- 收稿日期: 2022-03-07
- 网络出版日期: 2022-09-26

Early warning of the Braden individual score in the prevention of hospital pressure injury

Department of Nursing, Hwamei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang 315010, China

摘要

摘要: 目的探讨Braden单项评分管理对预防院内压力性损伤发生的预警作用，从而降低院内压力性损伤的发生率。方法成立由护理部、科护士长、伤口造口专科护士、病区护士长、病区压力性损伤质控员共同组成的网格化压力性损伤管理团队，将院区分为大、中、小3个网格进行督查和跟踪。对2020年1—12月，全院各病区通过OA(office automation)不良事件系统上报的81例院内发生的压力性损伤患者的Braden单项评分、发生部位和原因进行分析，2021年通过医惠系统统计全院Braden单项评分中潮湿、活动力及移动力3项评分＜3分的患者，系统导出后根据Braden单项评分管理预警来落实预防措施，观察措施落实后的压力性损伤发生情况。结果 2021年实施单项评分管理统计院内压力性损伤的发生率由2020年的0.125%降至0.085%。不良事件上报的院内压力性损伤患者中Braden单项评分(活动力、移动力、潮湿)其中一项或两项＜3分的患者由2020年的33例降至15例，差异有统计学意义(P＜0.05)。且其中压力性损伤分期以1期及2期为主，3期及深部组织损伤发生例数减少，压力性损伤患者愈合率明显上升。结论对Braden评分中低危风险及无风险患者落实单项评分管理，早期实施个体化压力性损伤护理干预，针对性落实各项预防措施，能有效降低院内获得性压力性损伤的发生率。
- Braden量表 /
- 压力性损伤 /
- 预防
Abstract: Objective To explore the effect of Braden's individual score in the prevention of hospital pressure injury (PI) to reduce the incidence of PI. Methods A grid management team composed of experts from the nursing department, the head nurses of the section, wound ostomy specialist nurses, the head nurses and the PI quality controller was established to monitor and track PI events in the whole hospital by dividing the team into three grid levels. We analysed Braden's individual score, the locations of PI, and the causes of PI in 81 cases reported by the office automation (OA) adverse event system in our hospital from January to December in 2020. We also calculated the Braden scores of moisture, activity and mobility less than 3 points in the medical benefit system in 2021; carried out preventive measures according to Braden's individual score management warning system; and observed PI events. Results After the implementation of individual scoring management, the incidence of in-hospital PI decreased from 0.125% in 2020 to 0.085% in 2021. The number of PI patients with one or two aspects less than 3 points amongst moisture, activity and mobility scorings decreased from 33 in 2020 to 15 in 2021, with a statistically significant difference between the two groups (P < 0.05). Stage three PI and deep tissue pressure injury were significantly reduced, and the healing rate of patients with PI increased dramatically. Conclusion Early intervention through Braden's individual score management and implementation of preventive measures to patients with mid-low and no risk through Braden's scoring can effectively reduce the incidence of in-hospital PI.
- Braden scale /
- Pressure injury /
- Prevention

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表 1 2020年不同Braden评分患者压力性损伤情况比较(例)

Table 1. Comparison of pressure injury in patients with different Braden scores in 2020 (cases)

评分类别	例数	发生	未发生
Braden评分≥13分且单项评分＜3分	455	33	422
Braden评分≥13分且单项评分≥3分	61 362	15	61 347
注：压力损伤情况比较，χ²=3 041.443，P＜0.001。

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表 2 2020—2021年压力性损伤发生情况比较(例)

Table 2. In 2020-2021 pressure damage occurrence compared (cases)

年份	例数	发生	未发生
2020	64 434	81	64 353
2021	74 776	64	74 712
注：压力损伤情况比较，χ²=5.354，P=0.021。

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表 3 2020—2021年Braden评分≥13分且单项评分＜3分的患者压力性损伤发生情况比较(例)

Table 3. Comparison of pressure injury in patients with Braden score ≥13 and single score < 3 from 2020 to 2021 (cases)

年份	例数	发生	未发生
2020	458	33	425
2021	512	15	497
注：压力损伤情况比较，χ²=9.396, P=0.002。

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表 4 2020—2021年患者发生压力性损伤的分期及转归比较(例)

Table 4. Comparison of stages and outcomes of pressure injuries in patients from 2020 to 2021 (cases)

年份	例数	分期				转归
年份	例数	1期	2期	3期	深部组织损伤	愈合	好转	无进展	死亡
2020	81	29	40	2	10	20	31	29	1
2021	64	45	16	1	2	38	19	6	1
Z值		-4.133				-4.541
P值		＜0.001				＜0.001

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