重症监护室新冠肺炎患者压力损伤风险评估和预防。

IF 2 Q2 NURSING

AACN Advanced Critical Care Pub Date : 2022-06-15 DOI:10.4037/aacnacc2022335

J. Alderden, S. Kennerly, Jill N. Cox, T. Yap

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引用次数: 3

摘要

背景新冠肺炎危重患者有医院所需压力损伤的风险，包括与设备相关的压力损伤。方法比较新冠肺炎患者和未患患者的raden量表预测有效性，并建立逻辑回归模型以确定设备相关压力损伤的危险因素。结果共有1920名患者被纳入研究样本，其中包括407名新冠肺炎患者。在后一组中，120名患者中每名患者至少发生1例医院获得性压力损伤（29%）；其中，55名患者（46%）出现了与设备相关的压力损伤。受试者操作特征曲线下的Braden量表评分区域在无新冠肺炎患者中为0.72，在新冠肺炎患者中为0.7，表明存在公平到差的歧视。结论机械通气支持过程中皮肤粗糙和俯卧位是设备相关压力损伤的危险因素。临床医生可以考虑在常规风险评估中纳入布雷登量表中未包括的因素（如氧合和灌注），并应保持警惕，以保护新冠肺炎患者免受设备相关压力损伤。

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Pressure Injury Risk Assessment and Prevention in Patients With COVID-19 in the Intensive Care Unit.

BACKGROUND Patients critically ill with COVID-19 are at risk for hospital-acquired pressure injury, including device-related pressure injury. METHODS Braden Scale predictive validity was compared between patients with and without COVID-19, and a logistic regression model was developed to identify risk factors for device-related pressure injury. RESULTS A total of 1920 patients were included in the study sample, including 407 with COVID-19. Among the latter group, at least 1 hospital-acquired pressure injury developed in each of 120 patients (29%); of those, device-related pressure injury developed in 55 patients (46%). The Braden Scale score area under the receiver operating characteristic curve was 0.72 in patients without COVID-19 and 0.71 in patients with COVID-19, indicating fair to poor discrimination. CONCLUSIONS Fragile skin and prone positioning during mechanical ventilatory support were risk factors for device-related pressure injury. Clinicians may consider incorporating factors not included in the Braden Scale (eg, oxygenation and perfusion) in routine risk assessment and should maintain vigilance in their efforts to protect patients with COVID-19 from device-related pressure injury.

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来源期刊

AACN Advanced Critical Care NURSING-

CiteScore

2.10

自引率

4.50%

发文量

期刊介绍： AACN Advanced Critical Care is a quarterly, peer-reviewed publication of in-depth articles intended for experienced critical care and acute care clinicians at the bedside, advanced practice nurses, and clinical and academic educators. Each issue includes a topic-based symposium, feature articles, and columns of interest to critical care and progressive care clinicians. AACN Advanced Critical Care contains concisely written, practical information for immediate use and future reference. Continuing education units are available for selected articles in each issue. AACN Advanced Critical Care is an official publication of the American Association of Critical-Care Nurses.