Development of an evidence-based protocol for the prevention of perioperative pressure injuries in pediatric cardiac surgery: A Delphi study

IF 2.4 3区医学 Q2 DERMATOLOGY

Journal of tissue viability Pub Date : 2025-07-23 DOI:10.1016/j.jtv.2025.100948

Xiangai Ma , Jialu Fan , Jiehui Wang , He Lin

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引用次数: 0

Abstract

Aim

Pediatric patients undergoing cardiac surgery are at high risk for perioperative pressure injuries (PPIs). This study aimed to develop an evidence-based protocol for the prevention of PPIs in pediatric cardiac surgery.

Methods

A literature review was conducted to identify and summarize the existing evidence on PPI prevention in pediatric cardiac surgery to construct an initial protocol. Two rounds of Delphi surveys were then performed to refine the protocol. The expert panel consisted of 20 multidisciplinary professionals from five tertiary hospitals, including nurses, surgeons, and anesthesiologists, 85 % of whom possess more than 20 years of clinical experience. The mean values of importance and feasibility of each indicator were calculated. Reliability of the Delphi method assessed by valid response rate, authority coefficient (Cr), coefficient of variation (CV) and Kendall’ W coefficient (Kendall’ W).

Results

Consensus was reached on 4 first-level items, 15 s-level items, and 27 third-level items for the PPI prevention protocol. The valid response rates for the two Delphi rounds were 83.3 % and 100 %, respectively, with Cr of 0.905 and 0.901, CV of less than 0.25, and Kendall’ W of 0.172 and 0.142 (P < 0.001).

Conclusion

The developed PPI prevention protocol for pediatric cardiac surgery is both scientific and feasible, providing a reference for perioperative nurses to implement systematic and standardized PPI prevention care.

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儿童心脏外科围手术期压力损伤预防循证方案的发展：德尔菲研究

摘要接受心脏手术的儿科患者围手术期压力损伤（PPIs）的风险较高。本研究旨在为儿童心脏手术中PPIs的预防制定循证方案。方法通过文献回顾，识别和总结现有的预防小儿心脏外科应用PPI的证据，构建初步方案。然后进行两轮德尔菲调查以完善方案。专家组由来自五所三级医院的20名多学科专业人员组成，包括护士、外科医生和麻醉师，其中85%具有20年以上的临床经验。计算各指标重要性和可行性的平均值。采用有效应答率、权威系数（Cr）、变异系数（CV）和Kendall ' W系数（Kendall ' W）评价德尔菲法的可靠性。结果对PPI预防方案的4个一级项目、15个s级项目和27个三级项目达成共识。两轮德尔菲的有效有效率分别为83.3%和100%，Cr分别为0.905和0.901，CV小于0.25,Kendall ' W分别为0.172和0.142 (P <；0.001)。结论制定的小儿心脏外科PPI预防方案科学可行，可为围手术期护士实施系统、规范的PPI预防护理提供参考。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of tissue viability DERMATOLOGY-NURSING

CiteScore

3.80

自引率

16.00%

发文量

110

审稿时长

>12 weeks

期刊介绍： The Journal of Tissue Viability is the official publication of the Tissue Viability Society and is a quarterly journal concerned with all aspects of the occurrence and treatment of wounds, ulcers and pressure sores including patient care, pain, nutrition, wound healing, research, prevention, mobility, social problems and management. The Journal particularly encourages papers covering skin and skin wounds but will consider articles that discuss injury in any tissue. Articles that stress the multi-professional nature of tissue viability are especially welcome. We seek to encourage new authors as well as well-established contributors to the field - one aim of the journal is to enable all participants in tissue viability to share information with colleagues.