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目的了解我国皮肤撕裂伤的现患率、发生现状及预防护理措施落实现状,为临床采取合理的护理措施提供参考依据。方法采用便利抽样法,抽取全国9个省、11个城市的14所三级甲等综合医院的19 010例住院患者实施横断面调查,使用前期通过Delphi法研制并经过预调研验证具有良好效度和可行性的调查工具。结果 19 010份问卷中获得有效问卷18 806份,18 806例患者中有199例计238处皮肤撕裂伤患者,现患率为1.058%,均发生于住院期间。238处皮肤撕裂伤患者中,1a级48处(20.2%),1b级34处(14.3%),2a级26处(10.9%),2b级14处(5.9%),3级116处(48.7%)。最常见的发生部位是双上肢,发生皮肤撕裂伤的前3位原因依次为跌倒(29.0%)、钝力损伤(23.1%)、医用敷料(19.7%)。199例皮肤撕裂伤患者中有164例患者有皮肤撕裂伤发生史,占82.4%,不同时间皮肤撕裂伤发生史的患者,其皮肤撕裂伤现患率比较,差异有统计学意义(χ~2=88.836,P<0.001)。199例皮肤撕裂伤患者中,9项预防措施仅有2项护理措施落实率>50%。结论14所三级甲等综合医院住院患者的皮肤撕裂伤现患率为1.058%,最常见的皮肤撕裂伤发生部位为双上肢,最常见的皮肤撕裂伤分级为3级,最常见的3个原因是跌倒、钝力损伤和移除医用粘性敷料。我国住院患者皮肤撕裂伤护理措施的实施情况较差,9项护理措施中仅有2项落实率>50%。临床医护人员需要加强对好发人群及部位的关注,加强对皮肤撕裂伤相关知识的学习,采用有针对的预防措施以减少皮肤撕裂伤的发生。
Objective To understand the current prevalence of skin laceration in China, its status quo and the status of implementation of preventive nursing measures, so as to provide reference for clinical reasonable nursing measures. Methods A total of 19 010 hospitalized patients from 14 tertiary level general hospitals in 9 provinces and 11 cities of China were surveyed by facilitation sampling method. And feasibility survey tools. Results A total of 18 806 valid questionnaires were obtained from 19 010 questionnaires. Among 18 806 patients, there were 199 cases with 238 cases of skin laceration and the prevalence was 1.058%, all of which occurred during hospitalization. Of the 238 patients with skin laceration, 48 were in stage 1a (20.2%), 34 were in stage 1b (14.3%), 26 were in stage 2a (10.9%), 14 were in stage 2b (5.9%), 116 were in stage 3 48.7%). The most common site of occurrence was upper extremity. The first three causes of skin laceration were fall (29.0%), blunt trauma (23.1%) and medical dressings (19.7%). Among the 199 patients with skin laceration, 164 patients had history of skin laceration, accounting for 82.4%. Patients with skin laceration at different time showed a significant difference in prevalence of skin laceration χ ~ 2 = 88.836, P <0.001). Among the 199 cases of skin laceration, only two of nine preventive measures were implemented and the implementation rate of> 50%. Conclusions The prevalence rate of skin laceration in inpatients in 14 tertiary level general hospitals is 1.058%. The most common skin laceration occurs in both upper extremities. The most common skin laceration is grade 3, the most common Three causes were falls, blunt trauma and removal of medical adhesive dressings. Inpatient skin injury in our hospital implementation of care measures in poor condition, nine nursing measures, only 2 implementation rate of> 50%. Clinicians need to focus their attention on areas and areas of good hair, enhance their knowledge of skin lacerations, and take targeted precautions to reduce the occurrence of skin lacerations.