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題名:比較傷口敷料處置於壓瘡預防之成效
書刊名:護理雜誌
作者:曹文昱羅淑芬 引用關係哈鐵木爾 引用關係李茹萍
作者(外文):Tsao, Wen-yiLo, Shu-fenHarmod, TomorLee, Ru-ping
出版日期:2013
卷期:60:4
頁次:頁65-75
主題關鍵詞:加護病房預防壓瘡親水性敷料泡棉敷料Intensive care unitPreventionPressure ulcerHydrocolloid dressingFoam dressing
原始連結:連回原系統網址new window
相關次數:
  • 被引用次數被引用次數:期刊(6) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:6
  • 共同引用共同引用:8
  • 點閱點閱:235
背景 傷口護理之高科技敷料於國內外臨床上廣為使用,但被用於預防壓瘡之成效,並無實證探討。目的:探討常規翻身護理處置與合併使用親水性敷料或泡棉敷料後,對預防尾薦骨壓瘡發生之成效。方法:採類實驗設計及方便取樣方式,以花蓮某醫院外科加護病患共90位為樣本,隨機分派至「常規翻身組」、「常規翻身合併使用親水性敷料組」或「常規翻身合併使用泡棉敷料組」。以Braden scale作為評估壓瘡風險工具,並採歐洲壓瘡諮詢委員會最新壓瘡分級標準用以每日檢視皮膚。資料分析以t檢定、ANOVA及曼—惠特尼U檢定。結果:「合併使用泡棉敷料組」之病人並未發生任何壓瘡。餘發生壓瘡比率以「常規翻身組」最高,其次為「合併使用親水性敷料組」,發生壓瘡等級以一、二級居多;然此兩組在發生壓瘡的時間上未達顯著差異。檢視「有發生壓瘡組」與「無發生壓瘡組」之間,其性別、高血壓史及身體質量指數變項均達顯著差異(p < .05)。結論/實務應用:建議對於臨床上高危險群病患,除了應採落實的更換姿位以及檢視皮膚之外,可視情況介入親水性敷料或泡棉敷料以預防尾薦骨壓瘡。
Background: Although high-technology wound dressings are widely used in clinical care worldwide, no evidence or discussions have been published regarding the efficacy of these dressings in preventing pressure ulcers.Purpose: This study presents a repositioning of routine management combined with hydrocolloid dressing or foam dressing for pressure ulcer prevention.Method: We used a quasi-experimental design and recruited a convenience sample of 90 from a surgical intensive care unit (SICU) at a medical center in Hualien County, Taiwan. Participants were allocated randomly to one of three groups: repositioning of routine management, hydrocolloid dressing, and foam dressing. Study instruments included a pressure ulcer risk table (Braden scale) and the pressure ulcer classification system of the European Pressure Ulcer Advisory Panel. An independent sample t-test, ANOVA, and Mann-Whitney U test were used to verify research hypotheses.Results: The repositioning of routine management group had the highest pressure ulcer incidence rate, followed by the hydrocolloid-dressing group. The foam-dressing group recorded no pressure ulcers. Pressure ulcer occurrence grades were primarily level 1 and 2. There was no significance difference in pressure ulcer occurrence time between the repositioning of routine-management group and the hydrocolloid-dressing group. Finally, there were significant differences (p< .05) among gender, hypertension history, and BMI regardless of pressure ulcer incidences. Conclusion: It is recommended that patients in high-risk groups in clinical settings adopt strategies including repositioning and regular visual skin examinations. Also, hydrocolloid or foam dressings may be used as appropriate to prevent sacral pressure ulcers.
期刊論文
1.于博芮、李世代、林壽惠(2005)。台灣醫療院所壓瘡風險評估工具之臨床效度。台灣老年醫學雜誌,1(2),79-88。  延伸查詢new window
2.戴瑞芬、何修嫺、歐惠容(20090300)。放置水袋與壓瘡前期症狀關係之病例對照研究--以加護病房病患為例。榮總護理,26(1),66-73。new window  延伸查詢new window
3.Bergstrom, N、Braden, B.、Kemp, M、Champagne, M.、Ruby,E(1996)。Multi-site study of incidence of pressure ulcers and the relationship between risk level, demographic characteristics, diagnoses, and prescription of preventive interventions。Journal of the American Geriatrics,44(1),22-30。  new window
4.Braden, B. J.、Bergstrom, N.(1994)。Predictive validity of the Braden scale for pressure sore risk in a nursing home population。Research in Nursing and Health,17(6),459-470。  new window
5.Chaiken, N.(2012)。Reduction of sacral pressure ulcers in the intensive care unit using a silicone border foam dressing.。Journal of Wound Ostomy and Continence Nursing,39(2),10-1097。  new window
6.Compton, F.、Hoffmann, F.、Hortig, T、Strauss, M、Frey, J、Zidek, W.、Schäfer, J. H.(2008)。Pressure ulcer predictors in ICU patients: Nursing skin assessment versus objective parameters。Journal of Wound Care,17(10),417-424。  new window
7.Dini, V.、Bertone, M.、Romanelli, M.(2006)。Prevention and management of pressure ulcers。Dermatologic Therapy,19(6),356-364。  new window
8.Grey, J. E.、Harding, K. G.、Enoch, S.(2006)。Pressure ulcers。British Medical Journal,332(7539),472-475。  new window
9.Hampton, S.(2010)。An evaluation of a silicone adhesive shaped heel dressing。British Journal of Nursing,19(6),30-33。  new window
10.Lindgren, M.、Unosson, M.、Fredrikson, M.、Ek, A. C.(2004)。Immobility: A major risk factor for development of pressure ulcers among adult hospitalized patients: A prospective study。Scandinavian Journal of Caring Sciences,18(1),57-64。  new window
11.McInnes, E.(2004)。The use of pressure-relieving devices (beds, mattresses and overlays) for the prevention of pressure ulcers in primary and secondary care。Journal of Tissue Viability,14(1),4-6, 8, 10.。  new window
12.McInnes, E.、Jammali-Blasi, A.、Bell-Syer, S. E. M.、Dumville, J. C.、Cullum, N.、Middleton, V.(20150903)。Support surfaces for pressure ulcer prevention。Cochrane Database of Systematic Reviews,9。  new window
13.Ohura, N.、Ichioka, S.、Nakatsuka, T、Shibata, M(2005)。dressing materials for the prevention of shear force in the treatment of pressure ulcers。Journal of Wound Care,14(9),401-404。  new window
14.Pender, L. R、Frazier, S. K.(2005)。The relationship between dermal pressure ulcers, oxygenation and perfusion in mechanically ventilated patients。Intensive and Critical Care Nursing,21(1),29-38.。  new window
15.Pieper, B.、Sugrue, M、Weiland, M、Sprague, K、Heiman, C(1998)。Risk factors, prevention methods, and wound care for patients with pressure ulcers。Clinical Nurse Specialist,12(1),7-12.。  new window
16.Reddy, M.、Gill, S. S.、Rochon, P. A.(2006)。Preventing pressure ulcers: A systematic review。Jama: The Journal of the American Medical Association,296(8),974-984。  new window
17.Shahin, E. S. M、Dassen, T、Halfens, R. J. G(2008)。Pres sure ulcer prevalence in intensive care patients: A cross -sectional study.。Journal of Evaluation in Clinical Practice,14(4),563-568。  new window
18.Stotts, N. A.、Wu, H. S.(2007)。Hospital recovery is facilitated by prevention of pressure ulcers in older adults。Critical Care Nursing Clinics of North America,19(3),269-275。  new window
19.Terekeci, H.、Kucukardali, Y.、Top, C.、Onem, Y.、Celik, S.、Öktenli, Ç.(2009)。Risk assessment study of the pressure ulcers in intensive care unit patients。European Journal of Internal Medicine,20(4),394-397。  new window
20.Theaker, C.、Kuper, M、Soni, N(2005)。Pressure ulcer prevention in intensive care - A randomized control trail of two pressure-relieving devices。Anaesthesia,60(4),395-399。  new window
21.Thomas, D. R.(2001)。Improving outcome of pressure ulcers with nutritional interventions: A review of the evidence。Nutrition,17(2),121-125。  new window
22.Weststrate, J. T. M.、Heule, F.(2001)。Prevalence of PU, risk factors and use of pressure ulcer relieving mattresses in ICU patients。Connect the World of Critical Care Nursing,1(3),77-82。  new window
23.Whittington, K. T、Briones, R.(2004)。National prevalence and incidence study: 6-year sequential acute care data。Advances in Skin and Wound Care,17(9),490-494。  new window
24.Yepes, D.、Molina, F、Leon, W.、Perez, E(2009)。Incidenceand risk factors associated with the presence of pressure ulcers in critically ill patients。Medicina Intensiva,33(6),276-281。  new window
25.靳燕芬、吳蕙菱、林淑真、邱月璧(20060300)。某醫學中心住院病人壓瘡盛行率及發生壓瘡相關因素探討。長庚護理,17(1)=53,11-21。new window  延伸查詢new window
26.Faul, Franz、Lang, Alert-Georg、Erdfelder, Edgar、Buchner, Axel(2009)。Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses。Behavior Research Methods,41(4),1149-1160。  new window
27.Polit, Denise F.、Beck, Cheryl Tatano(2006)。The content validity index: Are you sure you know what's being reported? Critique and recommendations。Research in Nursing and Health,29(5),489-497。  new window
會議論文
1.Gehin, C.、Brusseau, E.、Meffre, R、Schmitt, P. M、Deprez, J.F、Dittmar, A(2006)。Which techniques to improve the early detection and prevention of pressure ulcers?。2006 International Conference of the IEEE Engineering in Medicine and Biology Society。New York, NY.。  new window
其他
1.Agency for Health Care Research and Quality(20111019)。Pressure ulcer in adults: Prediction and prevention,http://www.ncbi.nlm.nih.gov/books/NBK63915/。  new window
2.European Pressure Ulcer Advisory Panel.(2009)。Pressure ulcer treatment: Quick reference guide,http://www.epuap.org/guidelines/Final_Quick_Treatment.pdf。  new window
3.National Guideline Clearinghouse.(20111017)。Guideline synthesis: Prevention of pressure ulcers,http://guideline.gov/syntheses/synthesis.aspx?id=25078&search=prevention+of+pressure+ulcers。  new window
4.National Institute for Health and Clinical Excellence.(20110805)。Pressure ulcer risk assessment and prevention,http://www.nhs.uk/Conditions/Pressureulcers/Pages/Prevention.aspx。  new window
 
 
 
 
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