壓傷是住院病人常見的問題,亦是臨床護理照護品質重要指標之一。本單位2015年壓傷發生密度為0.34%,高於當年度院內護理部設定的閾值0.17%。故專案目的為降低血液腫瘤科住院病人壓傷發生密度。分析壓傷原因:護理師對壓傷認知不足、單位未有壓傷在職教育課程安排、未制定壓傷品管監測指標、翻身輔具不足。經擬定相關措施,舉辦相關在職教育、稽查翻身紀錄單使用、制定高危險壓傷病人品管監測指標、製作加強翻身小標語、運用合適敷料預防壓傷、增設減壓設備,提升護理師壓傷照護的正確性及落實度。經以上措施執行後,2017年8月至2019年8月單位壓傷發生密度,皆小於院內護理部當年設定閾值(2017年0.28%、2018年0.08%、2019年0.07%),期望藉此專案,進而提升護理照護品質。
Pressure injury is a common problem in hospitalized patients and one of the important indicators of clinical nursing care quality. The project unit is a hematology and oncology ward. The incidence of pressure injury was 0.34% in the project unit in 2015, which was higher than the threshold set by the nursing department of that year (0.17%) in our hospital. The purpose of the project was to reduce the incidence of pressure injuries to be lower than the threshold set by the nursing department. The project team investigated the causes of pressure injury and identified three reasons: inadequate knowledge of pressure injury, a lack of continuing education for pressure injury, and a shortage of proper aiding devices. After literature review was carried out and team discussion implemented, interventions focusing on organizing continuing education, auditing the use of repositioning sheets, developing quality indicators for high-risk pressure injury patients, creating slogans to enhance patient repositioning, using appropriate dressings to prevent bruises and adding decompression equipment were all introduced. After the implementation of the above interventions, the incidence of pressure injury in the hematology and oncology ward was less than the thresholds set by the nursing department over recent years (028% in 2017, 0.08% in 2018, and 0.07% in 2019). It is hoped that this project could improve the quality of nursing care for preventing pressure injury.