降低神經外科手術患者壓瘡發生率之方案

Program for Lowering the Incidence of Pressure Sores in Neurosurgical Patients

壓瘡一直是醫療院所普遍存在的問題之一，國內外文獻均指出，每年需支付相當大的醫療費用於治療壓瘡患者身上，而手術引起的壓瘡佔12-66%，其中神經外科患者因手術時間長，更易形成壓瘡。本專案小組統計手術室2004年5月至8月各科壓瘡發生比率，其中以神經外科最高為9.5%，經分析發現：同仁對壓瘡的認知及預防方法不一，故針對問題提出改善對策，制定壓瘡防護標準、增設壓瘡危險因子評估、建立護理品質追蹤改善制度、安排在職教育、設計棉捲做特殊防護、並施行個別輔導後，神經外科手術患者壓瘡發生率由9.5%降至7%，不僅達到良好的成效，並增加手術醫療團隊對預防壓瘡之共識，進而提升手術照護品質。

Pressure sores are one of the well known problems that occur in hospitals. As the literature on the subject indicates, a lot of money is expended in managing this problem every year, and 12-66% of pressure sores are caused during surgery. Patients who undergo neurosurgical procedures are susceptible to pressure sores because of lengthy operations. We collected data on patients with pressure sores who underwent surgery between May 2004 and August 2004, and found that the incidence of pressure sore in neurosurgical patients was 9.5%, which was the highest among all surgical patients. This project was developed to solve the problem of pressure sores by setting up standard preventive procedures, a nursing follow up system and continuing education courses, and utilizing cotton rolls to pad sites of pressure sores. The incidence of pressure sore in neurosurgical patients was reduced from 9.5% to 7% after the improvement project was carried out. The more concerned nurses are about pressure sores, the better the quality of operative nursing care.