提升腦損傷重症病人壓力性損傷癒合率

A Project to Improve the Healing Rate of Pressure Injury in Severe Cases with Brain Injury

本專案旨在提升腦損傷重症病人壓力性損傷癒合率。壓力性損傷是腦損傷重症病人照護上常見的問題，也是臨床成效指標之一，若無完善的照護，不僅會延長癒合時間，更可能會伴隨傷口感染，延長住院時間，甚至造成死亡。本單位2018年癒合率為26.08%，較近3年平均癒合率35.06%下降8.98%，因此觸發執行專案改善之動機。經分析後確立問題為：護理人員壓力性損傷知能不足、壓力性損傷分級評估工具不足、缺乏癒合結案機制及缺乏跨團隊合作。過程中經由在職教育、壓力性損傷測量工具及辨識圖卡運用、增加壓力性損傷專責人員建立固定稽核制度及跨團隊溝通模式的建立，壓力性損傷癒合率由26.08%提升至41.03%。除達目標值外，專案確實提高護理人員壓力性損傷知能，讓病人得到完善且高品質之照護。

Pressure injuries pose a common challenge in the care of critically ill patients with brain injuries, constituting a significant Clinical Performance Indicator. Inadequate management not only results in delayed healing but also elevates the risk of serious infections, prolonged hospital stays, and even mortality. In 2018, our pressure injury healing rate stood at 26.08%, notably lower than the three-year average of 35.06%. Upon analysis, identified issues included a lack of knowledge and proficiency among nursing personnel in managing pressure injuries, deficiencies in assessment tools for classifying such injuries, a mechanism for healing and case closure, and insufficient teamwork collaboration. To address these challenges, a special project was initiated in April 2019. The project employed in-service education, pressure injury assessment tools, and identification graph cards. Additionally, a regular auditing system for designated pressure injury personnel was implemented, and a cross-team communication model was established. As a result of these interventions, the healing rate of pressure injuries increased from 26.08% to 41.03%. This special project significantly improved nursing personnel's knowledge and proficiency in pressure injury treatment, particularly in severe cases with brain injuries.