降低高齡整合醫學病房住院病人壓力性損傷之發生率

Reducing the incidence of pressure injuries among hospitalized patients in an integrated geriatric medical ward

壓力性損傷為全球性的照護議題，常用來做為評估護理品質及醫療管理之重要指標。經查核發現：照顧者壓力性損傷照護認知不足、語言隔閡、不識字、衛教方式不一致、護理人員對於壓力性損傷分級判定能力不足、翻身枕數量不足、未舉辦在職教育、無稽核制度等，造成高齡整合醫學病房住院病人壓力性損傷之發生率高，故組成專案小組，期望藉由專案推動，降低高齡整合醫學病房住院病人壓力性損傷之發生率。擬定方案：插卡式掛圖翻身鐘、三角翻身枕、培養種子成員，舉辦在職教育及團體衛教、列入品管稽核、建構資訊化。經執行後，護理人員執行壓力性損傷照護之之認知正確率由62%提升至98%、照顧者對於住院病人壓力性損傷之認知正確率由48%提升至92%、高齡整合醫學病房住院病人壓力性損傷之發生率從0.2%下降至0%，顯示成效良好，住院病人壓力性損傷之發生率顯著下降。

Pressure injuries serve as a critical global indicator of nursing quality and healthcare management effectiveness, yet an Integrated Geriatric Medical Ward faced high incidence rates due to multifaceted challenges, including caregiver knowledge gaps, language barriers, and a lack of standardized auditing and equipment. To address these issues, a dedicated task force implemented a comprehensive intervention strategy that included the introduction of repositioning pocket charts, triangular positioning wedges, "seed" caregiver training, and the integration of digital auditing and educational protocols. The impact of these measures was profound: caregiver proficiency in pressure injury care rose from 62% to 98%, their clinical understanding improved from 48% to 92%, and the patient pressure injury incidence rate successfully dropped from 0.2% to 0%. These results demonstrate that a structured, multifaceted approach can effectively eliminate preventable pressure injuries and significantly enhance the quality of geriatric inpatient care.