The Japanese pressure ulcer surveillance study: a retrospective cohort study to determine prevalence of pressure ulcers in Japanese hospitals.
The Japanese pressure ulcer surveillance study: a retrospective cohort study to determine prevalence of pressure ulcers in Japanese hospitals.
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日本压疮监测研究：一项回顾性队列研究，旨在确定日本医院压疮的患病率。
DOI：
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发表时间：
2008
期刊：
影响因子：
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通讯作者：
G. Nakagami
中科院分区：
文献类型：
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作者：
H. Sanada;Y. Miyachi;T. Ohura;T. Moriguchi;Keiko Tokunaga;K. Shido;G. Nakagami
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目标。通过调查压疮（PU）的患病率来评估2002年10月引入的政府监管体系，并探讨患病率变化与医院内部结构和制度之间的关系。
方法
这项回顾性队列研究使用了日本 2582 家随机抽样的医院。调查问卷被邮寄到各类医院，包括大学医院、急症医院、急症和长期（混合护理）医院、长期护理医院和精神病医院。对连续 4 个时期（监管实施前 1 个月、实施后立即、6 个月后和 1 年后）压疮的患病率和严重程度以及患病率改善的相关因素进行了评估。
结果
监管前总患病率为4.26%，监管后立即下降至4.18%，6个月和1年后分别下降至3.95%和3.64%。监管出台前，入院后发生Ⅲ期和Ⅳ期压疮的总体比例分别为23.9%和10.9%，1年后分别逐渐下降至18.8%和8.1%。 PU 患病率改善的相关因素是交替充气床垫的充分分布（比值比 = 2.259，95% CI；1.091-4.679，P = 0.028）。
结论
政府监管对 PU 患病率的降低具有重要的临床影响。事实证明，针对医院结构的监管会影响医院护理质量的结果。
UNLABELLED
Aim. To evaluate the governmental regulation system introduced in October 2002 by investigating the prevalence of pressure ulcers (PUs) and to investigate the relationship between the change in prevalence and the structure and system within hospitals.
METHODS
This retrospective cohort study used 2582 randomly sampled hospitals in Japan. Questionnaires were mailed to each type of hospital, including university hospitals, acute hospitals, acute and long-term (mixed care) hospitals, long-term care hospitals, and psychiatric hospitals. Prevalence and severity of pressure ulcers over 4 consecutive periods (1 month before the introduction of regulation, immediately after the introduction, 6 months later, and 1 year later) and related factors for the improved prevalence were assessed.
RESULTS
The overall prevalence before the regulation was 4.26%, which decreased to 4.18% immediately after regulation, and to 3.95% and 3.64% 6 months and 1 year later, respectively. The overall proportion of Stage III and IV pressure ulcers acquired after admission was 23.9% and 10.9%, respectively, before introduction of regulation, and gradually decreased to 18.8% and 8.1%, respectively, after 1 year. The related factor for improved PU prevalence was sufficient distribution of alternating air mattresses (odds ratio = 2.259, 95% CI; 1.091-4.679, P = 0.028).
CONCLUSION
The governmental regulation had a clinically important effect on the decrease in PU prevalence. The regulation focused on the structure of hospitals was confirmed to influence the outcome of hospital care quality.