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护理学报 ›› 2020, Vol. 27 ›› Issue (15): 39-43.doi: 10.16460/j.issn1008-9969.2020.15.039

• 循证护理 • 上一篇    下一篇

预防术中俯卧位患者面部压力性损伤的最佳证据总结

廖园园, 周毅峰, 秦月兰, 陶美伊, 李珍   

  1. 湖南省人民医院 湖南师范大学附属一医院,湖南 长沙 410000
  • 收稿日期:2020-03-18 出版日期:2020-08-10 发布日期:2020-09-11
  • 作者简介:廖园园(1986-),女,湖南长沙人,硕士,主管护师。
  • 基金资助:
    湖南省卫生健康委员会指导项目(20200632)

Best Evidence Summary for Protecting Prone Positioned Patients from Intraoperative Facial Pressure Injury

LIAO Yuan-yuan, ZHOU Yi-feng, QIN Yue-lan, TAO Meiyi, LI Zhen   

  1. Hunan Provincial People's Hospital, the First Affiliated Hospital of Hunan Normal University, Changsha 410000, China
  • Received:2020-03-18 Online:2020-08-10 Published:2020-09-11

摘要: 目的 评价和总结预防术中俯卧位患者面部压力性损伤的最佳证据,为术中俯卧位患者面部压力性损伤的预防策略提供参考。方法 应用循证护理方法,针对术中俯卧位患者的面部压力性损伤提出问题,计算机检索国内外医学数据库、指南库、循证资源库及相关专业协会网站,手工查阅相关专业书籍中关于预防术中俯卧位患者面部压力性损伤的指南、证据总结、最佳实践信息、系统评价及专家共识类文献,由2名研究者对文献质量进行评价和证据提取。结果 共纳入6篇文献,其中指南4篇,证据总结2篇。经过评价,总结得出18条最佳证据,包括患者压力性损伤风险评估、压力性损伤预防措施、压力性损伤分类评估和质量管理4个方面。结论 本研究总结了预防术中俯卧位患者面部压力性损伤的最佳证据, 为临床形成专业、有效的预防策略提供参考。建议手术室护理人员应用证据时应根据所在医疗机构现有的环境、应用证据的促进及阻碍因素、患者意愿及偏好有针对性的选择和应用证据。

关键词: 手术室, 预防, 俯卧位, 面部压力性损伤

Abstract: Objective To evaluate and summarize the best evidence regarding the prevention of intraoperative facial pressure injury in prone positioned patients and to provide relevant evidence for the prevention of intraoperative facial pressure injury. Methods By evidence-based nursing method,we proposed some questions on facial pressure injury in prone positioned patients during the surgery then we searched guidelines,evidence summary(ES),best practice information sheet(BPIS),system evaluation(SR), recommendedpractices (RP)of the prevention for intraoperative facial pressure injury in prone positioned patients in medical databases at home and abroad, related professional association websites, and professional books. Two researchers evaluated the literature quality and extracted the evidence independently. Results Six articles including 4guidelines and 2 evidence summary were involved and 4 items of best evidence and 18 pieces of best evidence were summarized, including risk assessment, prevention measures, pressure injury stage assessment and quality management. Conclusion This study summarizes the best evidence for the prevention of intraoperative facial pressure injuries in prone positioned patients, which provides professional and effective prevention strategies for clinical practice.It is suggested that the operating room nurses should take factors including medical environment, factors promoting and impeding the application of evidence, and the patient's willingness and preference into consideration to use the best evidence.

Key words: operating room, prevention, prone position, facial pressure injury

中图分类号: 

  • R632.1
[1] National Pressure Ulcer Advisory Panel (NPUAP).Announces a Change in Terminology from Pressure Ulcer to Pressure Injury and Updates the Stages of Pressure Injury[EB/OL]. (2016-04-13)[2020-02-21]. http://www.npuap.org/national-pressure-ulcer-advisory-panel-npuap-announces-a-change-in-terminology-from-pressure-ulcer-topressure-injury-and-updates-the-stages-of-pressure-injury/.
[2] 邓欣,吕娟,陈佳丽,等. 2016年最新压疮指南解读[J].华西医学,2016,31(9):1496-1498.DOI:10.7507/1002_0179.201600408.
[3] 王艳. 脊柱后路手术俯卧位中颜面部压疮预防体位用具的研究进展[J].全科护理,2018,16(1):37-40. DOI:10.3969/j.issn.1674-4748.2018.01.012.
[4] 李伟娟,胡爱玲,郑美春.现代伤口与肠造口临床护理实践[M]. 北京:中国协和医科大学出版社,2010:115.
[5] 魏革,胡玲,祝发梅.手术患者压疮风险因素评估表的设计与应用[J].中华护理杂志,2011,46(6):578-580. DOI:10.3761/j.issn.0254-1769.2011.06.018.
[6] 蒋晶,孙丽.脊柱手术防面部压疮交替充气式体位枕的研制[J].护理学报,2016,23(21):77-78.DOI:10.16460/j.issn1008-9969.2016.21.077.
[7] Avsar P, Patton D,O'Connor T,et al. Do We Still Need to Assess Nurses' Attitudes towards Pressure Ulcer Prevention? A Systematic Review[J].MA Healthcare,2019,28(12):795-806. DOI:10.12968/jowc.2019.28.12.795.
[8] Dicenso A, Bayley L, Haynes RB.Accessing Pre-appraised Evidence: Fine-tuning the 5s Model into a 6s Model[J]. Evid Based Nurs, 2009,12(4):99-101.DOI:10.1136/ebn.12.4.99-b.
[9] Brouwers MC, Kho ME, Browman GP, et al.AGREE II:Advancing Guideline Development, Reporting and Evaluationin Health Care[J]. J Clin Epidemiol, 2010,63(12):1308-1311.DOI:10.1016/j.ypmed.2010.08.005.
[10] 周英凤,顾莺,胡雁,等.JBI循证卫生保健中心关于不同类型研究的质量评价工具——干预性研究的质量评价[J].护士进修杂志,2018,33(2):112-113. DOI:10.16821/j.cnki.hsjx.2018.02.006.
[11] 王春青,胡雁.JBI 证据预分级及证据推荐级别系统(2014版)[J]. 护士进修杂志,2015, 30(11):964-967.DOI:1002-6975(2015)11-0964-04.
[12] European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Paneland ,Pan Pacific Pressure Injury Alliance.Prevention and Treatment of PressureUlcers/Injuries: Quick Reference Guide[EB/OL].(2019-11-14)[2020-02-21]. http://www.internationalguideline.com/static/pdfs/Quick_Reference_Guide-10Mar2019.pdf
[13] Wound, Ostomy and Continence Nurses Society-Wound Guidelines Task Force. WOCN 2016 Guideline for Prevention and Management of Pressure Injuries (Ulcers): An Executive Summary[J]. J Wound Ostomy Continence Nurs,2017,44(3):241-246.DOI:10.1097/WON.0000000000000321.
[14] 郭莉. 手术室护理实践[M].北京:人民卫生出版社,2019:50-53.
[15] National Institute for Health and Care Excellence.Pressure Ulcers: Prevention and Management.Clinical guideline[EB/OL].(2014-04-23) [2020-02-21]www.nice.org.uk/guidance/cg179.
[16] 胡延秋,陈捷茹,华玮,等.手术室压疮风险评估的最佳证据总结[J].中国实用护理杂志,2019,35(20):1551-1556.DOI:10.3760/cma.j.issn.1672_7088.2019.20.007.
[17] Wise V. Evidence Summaries. Pressure Injury Prevention Strategies:Surgical Procedures.(2019-07-24)[2020-02-21].https://ovidsp.dc2.ovid.com/sp-4.07.0b/ovidweb.cgi?&S=ACJDFPBKMBEBBPKGIPAKMFOGCFHOAA00&Complete+Reference=S.sh.19%7c1%7c1&Counter5=SS_view_found_complete%7cJBI13516%7cjbi%7cjbidb%7cjbi&Counter5Data=JBI13516%7cjbi%7cjbidb%7cjbi.
[18] National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel and Pan Pacifc Pressure Injury Alliance. Prevention and Treatment of Pressure Ulcers: Quick Reference Guide.[EB/OL].(2014-08-01)[2020-02-21].http://www.internationalguideline.com/static/pdfs/NPUAP_ EPUAP_PPPIA_PUQuickReferenceGuide_PanPacific_2016update.pdf.
[19] Stansby G,Avital L,Jones K,et al.Prevention and Management of Pressure Ulcers in Primary and Secondary Care: Summary of NICE Guidance[J]. BMJ,2014,23(348):g2592. DOI:10.1136/bmj.g2592.
[20] Lizarondo L. Evidence Summary. Pressure Injury: Accuracy in Classification and Documentation[EB/OL].(2017-06-14) [2020-02-21].http://ovidsp.dc2.ovid.com/sp_3.33.0b/ovidweb.cgi?&S=HNFLFPCBKEEBDPDCIPCKHGEHAJFNAA00&Link + Set=S.sh.21% 7c1%7csl 190.
[21] Alvey B, Hennen N, Heard H.Improving Accuracy of Pressure Ulcer Staging and Documentation Using a Computerized Clinical Decision Support System[J]. J Wound Ostomy Continence Nurs, 2012,39(6):607-612. DOI:10.1097/WON.0b013e31826a4b5c.
[22] Thomas A.Assessment of Nursing Knowledge and Would Documentation Following a Pressure Ulcer Educational Program in a Long-term Care Facility: A Capstone Project[J]. Wound Pract Res,2012,20(3):142-158.
[23] Bergstrom N, Braden BJ, Laguzza A, et al.The Braden Scale for Predicting Pressure Sore Risk[J].Nurs Res, 1987, 36(4):205-210.
[24] Norton D.Norton Revised Risk Sores[J]. Nursing Times, 1987, 83(41):6.
[25] Waterlow J.Pressure Sores:A Risk Assessment Card[J].Nurs Times, 1985, 81(48):49-55.
[26] Munro CA.The Development of a Pressure Ulcer Riskassessment Scale for Perioperative Patients[J].AORN J, 2010, 92(3):272-287. DOI:10.1016/j.aorn.2009.09.035.
[27] 童琍琍,赵梅,杨玉英,等.汉化版Munro成人手术室压疮风险评估表在全身麻醉手术中的应用研究[J].重庆医学,2018,47(10):1336-1339.
[28] Nazerali RS, Song KR, Wong MS.Facial Pressure Ulcer Following Pronepositioning[J]. JPRAS,2010,63(4):e413-414. DOI:10.1016/j.bjps.2009.11.001.
[29] Lee WY, Lin PC, Weng CH, et al.A Project to Reduce the Incidence of Facial Pressure Ulcers Caused by Prolonged Surgery with Prone Positioning[J].Hu li za zhi, 2012, 59(3):70-78.
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