医疗器械相关压力性损伤预防和管理的最佳证据总结
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摘要
目的探讨分析医疗器械相关压力性损伤预防及管理的证据,为临床护理人员采取针对性护理提供依据。方法采用循证方法,检索数据库及专业网站的相关文献,应用2012版临床指南研究与评价系统、2014版JBI证据预分级、证据推荐级别系统对文献进行质量评价和证据级别评定。结果最终纳入4篇指南和1篇证据总结,归纳得出22条证据,包括风险评估、医疗器械的选择和佩戴、皮肤和医疗器械的评估、预防措施4个方面。结论临床护理人员应重视医疗器械相关压力性损伤的预防及管理,根据具体临床情境、患者意愿有针对性地选择证据进行应用。
Objective To summarize best evidence regarding prevention and management of medical device related pressure injuries, and to provide references for clinical nurses.Methods By referencing to evidence-based methods, we searched electronic databases and professional websites to retrieve publications regarding prevention and management of medical device related pressure injuries. Then we used the Appraisal of Guidelines for Research and Evaluation instrument(AGREE Collaboration, 2012), the 2014 JBI evidence pre-grading, and the evidence recommendation system to evaluate the quality of the literature and identify the level of evidence.Results A total of 4 guidelines and 1 evidence summary were retrieved, and 22 pieces of evidence categorized into risk assessment, selection and wearing of medical devices, evaluation of skin and medical devices, and preventive measures, were summarized.Conclusion Clinical nurses should give heed to the prevention and management of medical device related pressure injuries, and select relevant evidence for application according to specific clinical situations and patient preferences.
Objective To summarize best evidence regarding prevention and management of medical device related pressure injuries, and to provide references for clinical nurses.Methods By referencing to evidence-based methods, we searched electronic databases and professional websites to retrieve publications regarding prevention and management of medical device related pressure injuries. Then we used the Appraisal of Guidelines for Research and Evaluation instrument(AGREE Collaboration, 2012), the 2014 JBI evidence pre-grading, and the evidence recommendation system to evaluate the quality of the literature and identify the level of evidence.Results A total of 4 guidelines and 1 evidence summary were retrieved, and 22 pieces of evidence categorized into risk assessment, selection and wearing of medical devices, evaluation of skin and medical devices, and preventive measures, were summarized.Conclusion Clinical nurses should give heed to the prevention and management of medical device related pressure injuries, and select relevant evidence for application according to specific clinical situations and patient preferences.
引文
[1] National Pressure Ulcer Advisory Panel.National Pressure Ulcer Advisory Panel announces a change in terminology from pressure ulcer to pressure injury and updates the stages of pressure injury[EB/OL].(2016-04-13)[2018-09-20].http://www.npuap.org/national-pressure-ulcer-advisory-panel-npuap-announces-a-change-in-terminology-from-pressure-ulcer-to-pressure-injury-and-updates-the-stages-of-pressure-injury.
[2] Black J,Alves P,Brindle C T,et al.Use of wound dressings to enhance prevention of pressure ulcers caused by medical devices[J].Int Wound J,2015,12(3):322-327.
[3] Coyer F M,Stotts N A,Blackman V S.A prospective window into medical device-related pressure ulcers in intensive care[J].Int Wound J,2015,11(6):656-664.
[4] Mohammad F A,Akram M R,Parameaswari P J,et al.A cross-sectional study on medical device-related pressure injuries among critically ill patients in Riyadh,Kingdom of Saudi Arabia[J].WCET J,2018,37(1):8-11.
[5] Black J M,Cuddigan J E,Walko M A,et al.Medical device related pressure ulcers in hospitalized patients[J].Int Wound J,2010,7(5):358-365.
[6] 杨小辉,赵媛媛,钮美娥.ICU医疗器械相关压力性损伤的研究现状[J].护理学报,2017,24(13):49-53.
[7] 韦当,王聪尧,肖晓娟,等.指南研究与评价(AGREEⅡ)工具实例解读[J].中国循证儿科杂志,2013,8(4):316-319.
[8] 王青春,胡雁.JBI证据预分级及证据推荐级别系统(2014版)[J].护士进修杂志,2015,30(11):964-967.
[9] Registered Nurses′ Association of Ontario.Risk assessment and prevention of pressure ulcers[EB/OL].[2018-09-20].http://rnao.ca/bpg/guidelines/riskassessment-and-prevention-pressure-ulcers.
[10] National Pressure Ulcer Advisory Panel,European Pressure Ulcer Advisory Panel,Pan Pacific Pressure Injury Alliance.Prevention and treatment of pressure ulcers:medical device related pressure ulcers-an extract from the clinical practice guideline[M].Osborne Park,Wes-tern Australia:Cambridge Media,2014:1-17.
[11] Wounds Australia.Standards for Wound Prevention and Management[M].3rd ed.Osborne Park,WA:Cambridge Media,2016:1-63.
[12] Health Quality &Safety Commission New Zealand.Gui-ding principles for pressure injury prevention and ma-nagement in New Zealand,2017 [EB/OL].(2017-05-01)[2018-09-20].https://www.nzwcs.org.nz/resources/publications/10-guidelines-and-protocols.
[13] Haesler E.Evidence Summary.Pressure injuries:preventing medical device related pressure injuries[J].The Joanna Briggs Institute.2017,11(30):1-4.
[14] 王家良.循证医学[M].北京:人民卫生出版社,2008:64-65.
[15] 黄海燕,米元元,喻姣花,等.危重症住院患者失禁相关性皮炎预防及护理的最佳证据总结[J].护理学杂志,2017,32(21):50-53.
[16] Makic M B F.Medical Device-Related Pressure Ulcers and Intensive Care Patients[J].J Peroanes Nur,2015,30(4):336-337.
[17] Newnam K M,McGrath J M,Salyer J,et al.A compa-rative effectiveness study of continuous positive airway pressure-related skin breakdown when using different nasal interfaces in the extremely low birth weight neonate[J].Appl Nurs Res,2015,28(1):36-41.
[18] 张艺,张建凤.PDCA在预防经口气管插管致口唇黏膜压力性损伤中的应用[J].护士进修杂志,2017,32(20):1906-1908.
[19] Padula C A,Paradis H,Goodwin R,et al.Prevention of medical device-related pressure injuries associated with respiratory equipment use in a critical care unit[J].J Wound Ostomy Continence Nurs,2017,44(2):138-141.
[20] 徐雲,蒋红,赵琦.ICU医疗器械相关压力性损伤研究进展[J].上海护理,2018,18(4):53-57.
[21] Kayser S A,Vangilder C A,Ayello E A,et al.Prevalence and analysis of medical device-related pressure injuries:results from the international pressure ulcer prevalence survery[J].Adv Skin Wound Care,2018,31(6):276-285.
[22] 刘亚红,李婷,付成成,等.ICU医疗器械相关性压疮的原因分析及对策[J].中华现代护理杂志,2014,20(11):1252-1254.
[23] 曹迎春,冯晓瑜,夏丽娟,等.病房护士对医疗器械相关性压疮认知现状的调查分析[J].国际医药卫生导报,2016,22(24):3891-3893.
[24] 周英凤,胡雁,朱政,等.JBI循证卫生保健模式的更新及发展[J].护理学杂志,2017,32(3):81-83.
[25] 成磊,胡雁.证据应用在循证护理实践的研究现状[J].护理学杂志,2016,31(3):101-105.
[2] Black J,Alves P,Brindle C T,et al.Use of wound dressings to enhance prevention of pressure ulcers caused by medical devices[J].Int Wound J,2015,12(3):322-327.
[3] Coyer F M,Stotts N A,Blackman V S.A prospective window into medical device-related pressure ulcers in intensive care[J].Int Wound J,2015,11(6):656-664.
[4] Mohammad F A,Akram M R,Parameaswari P J,et al.A cross-sectional study on medical device-related pressure injuries among critically ill patients in Riyadh,Kingdom of Saudi Arabia[J].WCET J,2018,37(1):8-11.
[5] Black J M,Cuddigan J E,Walko M A,et al.Medical device related pressure ulcers in hospitalized patients[J].Int Wound J,2010,7(5):358-365.
[6] 杨小辉,赵媛媛,钮美娥.ICU医疗器械相关压力性损伤的研究现状[J].护理学报,2017,24(13):49-53.
[7] 韦当,王聪尧,肖晓娟,等.指南研究与评价(AGREEⅡ)工具实例解读[J].中国循证儿科杂志,2013,8(4):316-319.
[8] 王青春,胡雁.JBI证据预分级及证据推荐级别系统(2014版)[J].护士进修杂志,2015,30(11):964-967.
[9] Registered Nurses′ Association of Ontario.Risk assessment and prevention of pressure ulcers[EB/OL].[2018-09-20].http://rnao.ca/bpg/guidelines/riskassessment-and-prevention-pressure-ulcers.
[10] National Pressure Ulcer Advisory Panel,European Pressure Ulcer Advisory Panel,Pan Pacific Pressure Injury Alliance.Prevention and treatment of pressure ulcers:medical device related pressure ulcers-an extract from the clinical practice guideline[M].Osborne Park,Wes-tern Australia:Cambridge Media,2014:1-17.
[11] Wounds Australia.Standards for Wound Prevention and Management[M].3rd ed.Osborne Park,WA:Cambridge Media,2016:1-63.
[12] Health Quality &Safety Commission New Zealand.Gui-ding principles for pressure injury prevention and ma-nagement in New Zealand,2017 [EB/OL].(2017-05-01)[2018-09-20].https://www.nzwcs.org.nz/resources/publications/10-guidelines-and-protocols.
[13] Haesler E.Evidence Summary.Pressure injuries:preventing medical device related pressure injuries[J].The Joanna Briggs Institute.2017,11(30):1-4.
[14] 王家良.循证医学[M].北京:人民卫生出版社,2008:64-65.
[15] 黄海燕,米元元,喻姣花,等.危重症住院患者失禁相关性皮炎预防及护理的最佳证据总结[J].护理学杂志,2017,32(21):50-53.
[16] Makic M B F.Medical Device-Related Pressure Ulcers and Intensive Care Patients[J].J Peroanes Nur,2015,30(4):336-337.
[17] Newnam K M,McGrath J M,Salyer J,et al.A compa-rative effectiveness study of continuous positive airway pressure-related skin breakdown when using different nasal interfaces in the extremely low birth weight neonate[J].Appl Nurs Res,2015,28(1):36-41.
[18] 张艺,张建凤.PDCA在预防经口气管插管致口唇黏膜压力性损伤中的应用[J].护士进修杂志,2017,32(20):1906-1908.
[19] Padula C A,Paradis H,Goodwin R,et al.Prevention of medical device-related pressure injuries associated with respiratory equipment use in a critical care unit[J].J Wound Ostomy Continence Nurs,2017,44(2):138-141.
[20] 徐雲,蒋红,赵琦.ICU医疗器械相关压力性损伤研究进展[J].上海护理,2018,18(4):53-57.
[21] Kayser S A,Vangilder C A,Ayello E A,et al.Prevalence and analysis of medical device-related pressure injuries:results from the international pressure ulcer prevalence survery[J].Adv Skin Wound Care,2018,31(6):276-285.
[22] 刘亚红,李婷,付成成,等.ICU医疗器械相关性压疮的原因分析及对策[J].中华现代护理杂志,2014,20(11):1252-1254.
[23] 曹迎春,冯晓瑜,夏丽娟,等.病房护士对医疗器械相关性压疮认知现状的调查分析[J].国际医药卫生导报,2016,22(24):3891-3893.
[24] 周英凤,胡雁,朱政,等.JBI循证卫生保健模式的更新及发展[J].护理学杂志,2017,32(3):81-83.
[25] 成磊,胡雁.证据应用在循证护理实践的研究现状[J].护理学杂志,2016,31(3):101-105.