摘要
目的将循证护理概念应用于无创通气的实践中,介绍自制防压疮棉罩的使用方法,并观察其应用效果。方法选择2017年9月至2018年4月河北医科大学附属哈励逊国际和平医院重症医学科(ICU)收治的50例无创通气序贯治疗患者作为观察组,通过检索国内外相关文献,查找临床证据,制定并实施具有循证护理理念的护理方案,应用自制防压疮棉罩预防患者面部压疮。以2017年1月至8月收治的40例无创通气序贯治疗患者作为历史对照组,采用传统水胶体敷料防压疮进行常规护理。比较两组患者面部压疮、眼部并发症发生率及更换敷料间隔时间和费用。结果所有患者均纳入最终分析。观察组患者面部压疮发生率明显低于对照组〔4.0%(2/50)比22.5%(9/40),P<0.05〕,且眼睑肿胀〔2.0%(1/50)比5.0%(2/40)〕、结膜充血〔2.0%(1/50)比5.0%(2/40)〕和刺激性角膜炎〔0%(0/50)比7.5%(3/40)〕等眼部并发症发生率也明显低于对照组(P<0.05)。由于自制防压疮棉罩便于随时更换,因此观察组更换敷料间隔时间较对照组明显缩短(min:1.5±0.5比2.0±0.5,P<0.05);但其可以清洗、交替使用,且价格低廉,因此敷料费用较对照组明显降低(元:30±10比123±20,P<0.01)。结论应用自制防压疮棉罩可明显减少无创通气序贯治疗患者面部压疮等并发症的发生。
Objective To apply the concept of evidence-based nursing to the practice of non-invasive ventilation, and to introduce the method of using self-made pressure-resistant cap cotton cover and its application effect. Methods Fifty patients on non-invasive ventilation admitted to intensive care unit (ICU) of Harrison International Peace Hospital Affiliated to Hebei Medical University from September 2017 to April 2018 were enrolled as observation group. By retrieved the relevant literature at home and abroad to look for clinical evidence, the concept of evidence-based nursing care program was formulated and implemented, and self-made pressure-resistant cap cotton cover was used to prevent facial pressure sores in patients on non-invasive ventilation. Forty non-invasive ventilation patients admitted from January to August in 2017 were enrolled as the historical control group, and conventional nursing was conducted by using traditional hydrocolloid dressings to prevent pressure ulcers. The incidence of facial pressure ulcers, ocular complications, dressing replacement time and cost were compared between the two groups. Results All patients were enrolled in the final analysis. The incidence of pressure ulcers in the observation group was significantly lower than that in the control group [4.0% (2/50) vs. 22.5% (9/40), P < 0.05], and the incidences of ocular complications such as eyelid swelling [2.0% (1/50) vs. 5.0% (2/40)], conjunctival congestion [2.0% (1/50) vs. 5.0% (2/40)] and irritant keratitis [0% (0/50) vs. 7.5% (3/40)] were also significantly lower than those in the control group (P < 0.05). Because the pressure-resistant cap cotton cover made by ourselves was easy to be replaced at any time, the interval time of dressing change in the observation group was significantly shorter than that in the control group (minutes: 1.5±0.5 vs. 2.0±0.5, P < 0.05). In addition it could be cleaned, used alternately, and the cost was low, so the dressing cost in the observation group was significantly lower than that in the con
作者
陈晓洁
张艳卿
房玮
张谨超
焦亚平
Chen Xiaojie;Zhang Yanqing;Fang Wei;Zhang Jinchao;Jiao Yaping(Department of Nursing,Harrison International Peace Hospital Affiliated to Hebei Medical University,Hengshui 053000, Hebei,China;Department of Critical Care Medicine,Harrison International Peace Hospital Affiliated to Hebei Medical University,Hengshui 053000,Hebei,China)
出处
《中华危重病急救医学》
CAS
CSCD
北大核心
2019年第1期118-121,共4页
Chinese Critical Care Medicine
基金
国家实用新型专利(ZL201420167487.8)
河北省衡水市科技计划项目(2017014013C-05).
关键词
防压疮棉罩
无创通气序贯治疗
循证实践
Pressure-resistant cap cotton cover
Non-invasive ventilation sequential therapy
Evidence-based practice
