醫療器材相關壓力性損傷預防策略

Medical Device Related Pressure Injury Prevention Strategies

2016年美國國家壓瘡諮詢委員會之壓瘡名詞及分級全球專家共識會議，決議納入醫療器材相關壓力性損傷。可見此醫源性傷害逐漸受重視。相較於骨突處的壓力性損傷，可以運用翻身擺位緩解局部持續的壓力，醫療器材的安全固定與不可移除性，更增加臨床壓力性損傷預防與照護的困難度。再者，顏面皮膚與黏膜是最常見損傷發生部位，一旦發生，容易造成外貌毀損與功能喪失，甚而導致骨頭暴露引發感染，導致潛在醫療糾紛發生危機。因此近幾年來，國外開始針對此範疇進行探討與揭露，但國內目前對醫療器材相關壓力性損傷探討仍付之闕如，因此本文透過國內外文獻查證與結合臨床實證，針對醫療器材相關壓力性損傷的定義、危險因子、損傷分級、預防策略等進行全面闡述，以提供健康照護專業人員新知，期許能對臨床醫療器材相關壓力性損傷之預防與照護有所助益，以降低其發生率與傷害程度。 Medical Device Related Pressure Injury was incorporated into the redefinition of pressure injuries during the National Pressure Ulcer Advisory Panel 2016 Staging Consensus Conference. It is evident that this type of iatrogenic injury is gradually receiving more attention. Unlike pressure injuries over a bony prominence, which may be alleviated by repositioning different body parts, injuries that require non-retractable medical devices to be securely fastened to an injury site carry a higher risk of causing pressure injuries and of requiring subsequent care in a clinical setting. Furthermore, facial skin and mucosal membranes are the most common sites of Medical Device Related Pressure Injuries. Once these injuries occur, they easily result in damage to appearance, loss of function, and even bone exposure and infection, which may lead to medical disputes. Therefore, in recent years, research and exploration in this field has increased in many countries. However, discussions regarding Medical Device Related Pressure Injuries in Taiwan are still lacking. Thus, the aim of this article is to discuss the definition, risk factors, damage classification, and prevention strategies of Medical Device Related Pressure Injuries by combining domestic and international literature reviews and clinical verifications for the purpose of providing knowledge to medical staffs in hopes of reducing the incidence of Medical Device Related Pressure Injuries and degree of damage.