Author/Editor | Petkovšek Gregorin, Romana; Hribar, Katja; Vidmar, Gaj | |
Title | Pojavnost razjed zaradi pritiska in uporabnost ocenjevalnih lestvic ogroženosti za razjedo zaradi pritiska pri pacientih na bolnišnični rehabilitaciji | |
Translated title | Prevalence of pressure ulcers and feasibility of rating scales for assessing risk of pressure ulcer in rehabilitation inpatients | |
Type | članek | |
Vol. and No. | Letnik 12, št. 2 | |
Publication year | 2013 | |
Volume | str. 4-12 | |
ISSN | 1580-9315 - Rehabilitacija | |
Language | slv | |
Abstract | Izhodišče: Razjeda zaradi pritiska se pojavlja tako doma kot tudi v vseh bolnišnicah in domovih starejših občanov. Vpliva na slabšo kakovost pacientovega življenja in na potek bolezni. Preprečevanje nastanka razjede zaradi pritiska je učinkovitejše od zdravljenja. Za oceno ogroženosti za nastanek take razjede se uporabljajo različne ocenjevalne lestvice. Namen naše raziskave je bil oceniti pojavnost razjede v naši rehabilitacijski bolnišnici in ugotoviti, ali obstaja povezava med ocenami na lestvici Waterlow in lestvici funkcijske neodvisnosti FIM. Metode: Uporabili smo kvantitativno neeksperimentalno raziskovalno metodologijo. Vključili smo paciente, ki so bili hospitalizirani na URI-Soča v Ljubljani, na vseh oddelkih razen na otroškem, od 1. januarja 2012 do 30. aprila 2012. Vključili smo vsakega drugega pacienta, zapisanega v sprejemni knjigi, na posameznem oddelku. S kontrolnimi listami smo spremljali paciente in njihovo ogroženost za nastanek razjede zaradi pritiska v štirinajstdnevnih časovnih razmikih. Medicinske sestre so podatke zapisovale trikrat med rehabilitacijo in četrtič ob pacientovem odpustu. Rezultati: V raziskavo je bilo vključenih 228 pacientov. Ob sprejemu je povprečna ocena na lestvici Waterlow znašala15,7 točke, povprečna ocena motoričnega FIM-a pa 54,7točke. Med ocenami na lestvici Waterlow in motorični podlestvici FIM je bila ob sprejemu in odpustu statistično značilna in razmeroma visoka negativna korelacija (sprejem: Spearmanov = 0,641, p < 0,001; odpust: Spearmanov = 0,621, p < 0,001). Ob sprejemu razjede zaradi pritiska ni imelo 83,8 % hospitaliziranih pacientov, pri 8,3 % pacientov pa je bila prisotna; ob odpustu razjede ni imelo 90,4 % pacientov, 5,3 % pa jo je še vedno imelo. Ob odpustu je prišlo do statistično značilnega izboljšanja razjede zaradi pritiska (eksaktni razširjeni McNemarovtest: p = 0,001). Izid zdravljenja ni bil jasno povezan s stopnjo sodelovanja pacienta ob sprejemu, pa tudi ne z oceno motoričnega FIM-a ob sprejemu, bil pa je povezan z napredkom na motoričnem FIM-u ob odpustu v primerjavi s sprejemom (p = 0,002). Zaključek: Ocenjevanje pacientov glede tveganja za nastanek razjede zaradi pritiska je pomemben del dela medicinskih sester pri preprečevanju njenega nastanka. Z združevanjem obstoječih ocenjevalnih lestvic bi omogočili medicinskim sestram, da bi prihranjeni čas namenile delu s pacienti, toda za to bodo potrebne nadaljnje raziskave.Introduction: Pressure ulcers occur at home as well as in all hospitals and nursing homes. They worsen the patients quality of life and the course of the illness. Prevention of the occurrence of pressure ulcers is more effective than treatment. Different rating scales are used for assessing the risk of occurrence of pressure sores. The aim of our study was to estimate the prevalence of pressure ulcers in our rehabilitation hospital and to find out whether there is an association between the Waterlow scale scores and the Functional Independence Measure (FIM) scores. Methods: We employed quantitative non-experimental research methodology. We included the patients hospitalised at the University Rehabilitation Institute in Ljubljana (except in the childrens ward) between 1 January 2012 and 30 April 2012. The records of every second patient admitted within each department were analysed. A checklist was used to follow the patients and their risk of developing a pressure ulcer in 14-day intervals. The nurses recorded the data three times during the inpatient rehabilitation and the fourth time upon the patients discharge. Results: The research involved 228 patients. The mean Waterlow score was 15.7 points and the mean motor FIM score was 54.7 points at admission. At admission, 83.8% of the patients had no pressure ulcer and 8.3% had a pressure ulcer; at discharge, 90.4% of the patients had no pressure ulcer and 5.3% still had a pressure ulcer. There wasa statistically significant improvement in pressure ulcer occurrence (exact extended McNemar test: p = 0.001).The outcome of pressure ulcer treatment was not clearly associated either with patient compliance or with motor FIM score at admission, but it was correlated with the progress in motor FIM at discharge with respect to admission (p = 0.002). Conclusion: Evaluation of patients regarding the risk of pressure ulcer development is an important part of the nurses work in preventing pressure ulcers. By combining the rating scales presently in use, the nurses would save time and could dedicate more time to work with the patients, but further studies are needed to achieve that goal. | |
Descriptors | Pressure ulcer | |
Keywords | rating scales patient risk razjeda zaradi pritiska ocenjevalne lestvice ogroženost pacienta |