Documentation of preventive care for pressure ulcers initiated during annual evaluations in SCI
Documentation of preventive care for pressure ulcers initiated during annual evaluations in SCI
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SCI 年度评估期间启动的压疮预防护理记录
DOI：
10.1080/10790268.2015.1114225
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
B. Bates
中科院分区：
文献类型：
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作者：
M. Guihan;D. Murphy;Thea J. Rogers;R. Parachuri;Michael Sae Richardson;Kenneth K Lee;B. Bates
目的：社区获得性压疮(PRU)是退伍军人脊髓损伤(SCI)住院的常见原因。退伍军人健康管理局(VHA)建议SCI年度评估包括评估PRU风险因素，进行彻底的皮肤检查，并分享PRU预防策略的建议。在对退伍军人进行SCI的年度评估中，我们将预防性皮肤护理的一致性描述为确定战略的第一步，以在其他医疗保健活动中更积极地促进PRU预防护理。设计/地点/对象：回顾性横断面观察性设计，包括回顾2011年1月至12月在2个退伍军人脊髓损伤中心住院的206名患有脊髓损伤的退伍军人的电子病历。结果衡量：记录的适用皮肤健康元素的比例(记录的适用元素/皮肤健康元素的数量)。结果：我们的样本主要是白人(78%)，男性(96.1%)，平均年龄 = 61岁。40%的参与者因PRU治疗而住院，从年度评估到指数入院平均294d(中位数 = 345d)。平均而言，退伍军人平均获得了75.5%(IQR 68-86%)的适用皮肤健康元素。在住院患者与门诊患者的年度评估中，适用的皮肤健康要素的记录显著更高(平均要素分别为 = 的80.3%和64.3%，P>；0.001)。在高风险退伍军人和低风险退伍军人的皮肤健康要素记录中，没有观察到显著的差异。结论：在VHA门诊环境中增加PRU预防服务可能会增加对社区脊髓损伤退伍军人PRU危险因素的识别和检测，并使早期干预成为可能。
Objective: Community-acquired pressure ulcers (PrUs) are a frequent cause of hospitalization of Veterans with spinal cord injury (SCI). The Veterans Health Administration (VHA) recommends that SCI annual evaluations include assessment of PrU risk factors, a thorough skin inspection and sharing of recommendations for PrU prevention strategies. We characterized consistency of preventive skin care during annual evaluations for Veterans with SCI as a first step in identifying strategies to more actively promote PrU prevention care in other healthcare encounters. Design/setting/participants: Retrospective cross-sectional observational design, including review of electronic medical records for 206 Veterans with SCI admitted to 2 VA SCI centers from January-December, 2011. Outcome measures: Proportion of applicable skin health elements documented (number of applicable elements/skin health elements documented). Results: Our sample was primarily white (78%) male (96.1%), and mean age = 61 years. 40% of participants’ were hospitalized for PrU treatment, with a mean of 294 days (median = 345 days) from annual evaluation to the index admission. On average, Veterans received an average of 75.5% (IQR 68-86%) of applicable skin health elements. Documentation of applicable skin health elements was significantly higher during inpatient vs. outpatient annual evaluations (mean elements received = 80.3% and 64.3%, respectively, P > 0.001). No significant differences were observed in documentation of skin health elements by Veterans at high vs. low PrU risk. Conclusion: Additional PrU preventive care in the VHA outpatient setting may increase identification and detection of PrU risk factors and early PrU damage for Veterans with SCI in the community, allowing for earlier intervention.