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題名:運用皮膚照護群組模式降低肺癌住院病人壓瘡發生密度之成效
書刊名:護理雜誌
作者:林文綾曾健華鍾宜真莊心筑林筠嵐張碧華
作者(外文):Lin, Wen-lingTseng, Chien-huaChung, Yi-jenChuang, Hsin-chuLin, Yun-lanChang, Pi-hua
出版日期:2014
卷期:61:2(附冊)
頁次:頁85-94
主題關鍵詞:照護群組肺癌壓瘡Care bundlesLung cancerPressure ulcer
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(1) 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:1
  • 共同引用共同引用:8
  • 點閱點閱:10
背景:壓瘡是皮膚受到任何漸進性傷害後形成的組織缺損,屬於皮膚完整性照護的問題,也是重要的臨床品質指標。自2010年1月至2011年3月肺癌住院病人的壓瘡發生密度平均值約2.09%,明顯高出其他住院病人約8倍之多,分析原因為缺乏照護標準、病人特性、以及護理員人評估不完整等。目的:本專案目的為運用皮膚照護群組模式降低肺癌住院病人壓瘡發生密度。解決方案:實施壓瘡預防群組實證措施、增加壓瘡高危險群照護對象及教導使用「壓瘡預防策略照護群組表」紀錄,進行日常照護活動。結果:從2011年11月到2012年1月的專案執行期間,肺癌住院病人壓瘡發生密度降至0.55%,之後8個月的效果追蹤亦可維持每月在0.33%。結論:藉由「照護群組」概念,建立實證照護標準作業,持續強化臨床護理人員照護能力及經驗,進行壓瘡品質監控,嘉惠更多病人。
Background & Problems: Pressure ulcers are tissue defects that form on the skin as a result of progressive skin damage. Pressure ulcers are a skin-integrity-related care issue and an important clinical indicator of care quality, especially for lung cancer inpatients who face rapidly deteriorating health conditions due to multiple symptoms and the side effects of treatment. Treating severe pressure ulcers may consume considerable manpower, time, and medical resources. Pressure ulcers may be avoided or effectively treated when nurses conduct proper skin assessments and care for wounds properly.Purpose: This project evaluates the efficacy of skin care bundles in terms of reducing the incidence density of pressure ulcers in lung cancer inpatients.Resolution: Data gathered between January 2010 and March 2011 showed unstable incidence density for pressure ulcers. The average pressure-ulcer incidence density in lung cancer inpatients was 2.09%, which was 8-times higher than the average for all patients. Using evidence-based care bundles for pressure ulcer prevention, we trained nurse staffs to incorporate these bundles into their clinical daily care of lung cancer patients in our hospital.Results: During the study period between November 2011 and January 2012, the pressure-ulcer incidence density gradually fell to 0.55%. The incidence density continued to fall to 0.33% over the subsequent 8 months.Conclusions: We used the concept of "care bundles" to establish a standard skin-care protocol for advanced lung cancer inpatients. This protocol improved the clinical ability of nursing staffs and effectively maintained skin care quality in lung cancer patients.
期刊論文
1.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
2.Bethell, E.(2003)。Controversies in classifying and assessing grade I pressure ulcers。Journal of Wound Care,12(1),33-36。  new window
3.Russell, L.(2002)。Pressure ulcer Classification : Defining early skin damage。British Journal of Nursing,11(16,Suppl),33-41。  new window
4.曾嶔元(2010)。非小細胞肺癌的回顧與標靶治療現況。生物醫學,3(1),332-350。  延伸查詢new window
5.劉會平(20041200)。肺癌胗斷與治療。腫瘤護理雜誌,4(2),25-34。  延伸查詢new window
6.Ayello, E. A.、Braden, B.(2002)。How and why to do pressure ulcer risk assessment。Advances in Skin & Wound Care,15(3),125-131。  new window
7.Clark, M.(2009)。Innovations in pressure ulcer prevention and management: New international guidelines for best practice。Wounds International,1(1)。  new window
8.Kris, M. G.、Natale, R. B.、Herbst, R. S.、Lynch, T. J., Jr.、Prager, D.、Belani, C. P.、Kay, A. C.(2003)。Efficacy of gefitinib, an inhibitor of the epidermal growth factor receptor tyrosine kinase, in symptomatic patients with non-small cell lung cancer: A randomized trial。JAMA: The Journal of the American Medical Association,290(16),2149-2158。  new window
9.Lyder, C. H.(2006)。Effective management of pressure ulcers. A review of proven strategies。Advance for Nurse Practitioners,14(7),32-37。  new window
10.Maida, V.、Corbo, M.、Dolzhykov, M.、Ennis, M.、Irani, S.、Trozzolo, L.(2008)。Wounds in advanced illness: A prevalence and incidence study based on a prospective case series。International Wound Journal,5(2),305-314。  new window
11.Murphy, M.、Stordal, B.(2011)。Erlotinib or gefitinib for the treatment of relapsed platinum pretreated non-small cell lung cancer and ovarian cancer: A systematic review。Drug Resistance Updates,14(3),177-190。  new window
12.Pan, H. H.、Lin, K. C.、Ho, S. T.、Liang, C.-Y.、Lee, S. C.、Wang, K. Y.(2012)。Factors related to daily life interference in lung cancer patients: A cross-sectional regression tree study。European Journal of Oncology Nursing,16(4),345-352。  new window
13.Stratton, R. J.、Ek, A.-C.、Engfer, M.、Moore, Z.、Rigby, P.、Wolfe, R.、Elia, M.(2005)。Enteral nutritional support in prevention and treatment of pressure ulcers: A systematic review and meta-analysis。Ageing Research Reviews,4(3),422-450。  new window
14.吳祚光、鍾文珍、程麗玲、戴宏達(20090600)。脊椎手術壓瘡預防與減壓擺位裝置之探討。榮總護理,26(2),121-126。new window  延伸查詢new window
15.張美玉、王富瑩、王筱華、王凱君、張靜雯(20091200)。加護病房實施「存留導尿管照護群組」之成效評價。榮總護理,26(4),336-345。new window  延伸查詢new window
16.趙莉芬、劉雪娥(19951200)。病人家屬對壓瘡預防措施及其危險因子認知程度的差異與相關因素之探討。護理研究,3(4),365-375。new window  延伸查詢new window
17.Bale, S.、Tebble, N.、Jones, V.(2004)。The benefits of implementing a new skin care protocol in nursing homes。Journal of Tissue Viability,14(2),44-50。  new window
18.Braden, B.、Bergstrom, N.(1987)。A conceptual schema for the study of the etiology of pressure sores。Rehabilitation Nursing,12(1),8-12。  new window
19.Thompson, D.(2005)。A critical review of the literature on pressure ulcer aetiology。Journal of Wound Care,14(2),87 -90。  new window
圖書
1.李佳諭、張瑩如、陳貞如(2008)。壓瘡預防與照護臨床照護指引。台南市:國立成功大學醫學院附設醫院護理部實證護理推展計畫發展小組。  延伸查詢new window
2.許美玉、王淑貞、王琬詳、張惠冠、戴佳惠(2009)。成人失禁性皮膚炎之預防與處置臨床指引。台北市:衛生署。  延伸查詢new window
3.Baharestani, M.、Black, J.、Carville, K.、Clark, M.、Cuddigan, J.、Dealey, C.、Sanada, H.(2009)。Pressure ulcer prevention: Prevalence and incidence in context. A consensus document。London, England:Medical Education Partnership。  new window
4.Carey, R. G.、Stake, L. V.(2003)。Improving healthcare with control charts: Basic and advanced SPC methods and case studies。Milwaukee, WI:William A. Tony。  new window
其他
1.醫院評鑑暨醫療品質策進會(2013)。台灣臨床成效指標系統,http://www.tjcha.org.tw/FrontStage/page.aspx?ID=D8ADC4BA-00B0-45AD-8B37-29519C30B821。  延伸查詢new window
圖書論文
1.Fong, K. M.、Clarke, B. E.、Bowman, R. V.(2006)。Tumors, malignant I metastases from lung cancer。Encyclopedia of respiratory medicine。Boston, MA:Elsevier。  new window
 
 
 
 
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