某教學醫院住院病人發生壓瘡之相關因素探討

Factors Related to Pressure Sore Occurrence of In-Patients at a Teaching Hospital

本研究以某教學醫院全部住院病人及急診留院觀察病人為對象（共計996人），進行壓瘡危險因子之評值及調查壓瘡發生狀況和壓瘡防治之護理活動，以建立壓瘡防治之護理品管模式。結果顯示：住院病人壓瘡發生率為5.6%，而壓瘡高危險群病人之發生率則為21.6%，其中臥床病人壓瘡發生率達36.8%。發生之部位，以尾椎處最多達50.0%；壓瘡級數以第0級和第1級居多，分別為50.0%和37.2%，以correlation coefficient及t-test分析，顯示病人之精神狀態、排便情形、活動性／可動性、局部感覺、皮膚狀況／循環及營養狀況六項壓瘡危險因子及其總分，以壓瘡之行程有顯著之相關性。壓瘡病人之護理紀錄、計畫之完成率及預防輔助器之使用均偏低。因此，極需要建立壓瘡高危險群病人之評估系統，發展壓瘡防治之護理品管制度，以作為長期監測及提升護理品質之用。

This study was conducted in a teaching hospital. From all in-patients (966 patients in total), the researcher classified 259 high risk patients (26% of all) for investigation. The purpose of this study was to explore the pressure sore incidence and nursing intervention in the hospital, to analyze the relationship between the risk factors and the incidence of pressure sores, and to establish a nursing quality assurance model for prevention and care of pressure sores. The results showed a pressure sore incidence rate of 5.6% for all patients and 21.6% rate for the high risk patients at the hospital. The pressure sore incidence rate of bedridden patients is the highest (36.8%). Most pressure sores are grade 0 or grade 1 and located on the sacral area. Correlation coefficient and t-test indicated the relationship between the risk factors and the incidence of the pressure sore. The use of nursing record, nursing care plans, and mechanical devices for pressure sores was low. Therefore, there is a strong need to develop a nursing quality assurance model for pressure sore prevention and care to long term monitoring and improving nursing care.