1/22 PREVALENCE AND TREATMENT OF PRESSURE ULCERS IN NORTHERN NEW SOUTH WALES 九樓內科病房 陳惠慈 文章出處： Aust. J. Rural Health (2000) 8, 103–110

2/22 ABSTRACT  This paper reports on a small, cross-sectional study of 18 hospitals in northern New South Wales.  Pressure ulcer prevention and treatment practices were varied  ranging from turning of the patient  occlusive dressings  such creative methods as exposure  sunshine  airing the wound.

3/22 INTRODUCTION 褥瘡是醫院內常見的, 尤其是長期照護臥 床的病人, 他們往往需較大的醫療資源, 而造成醫療資源浪費, 所以值得深入探討

4/22 METHODS  Sample selection  All hospitals with acute-care beds in the northeast, north coast, mid-north coast, far west and northwest health regions of New South Wales were invited to participate in the study. Of a total of 25 eligible hospitals, 18 (72%) agreed to participate in the present study.

5/22 Pressure ulcers were classified  Stage 1: non-blanchable erythema of intact skin,heralding lesion of skin ulceration; epidermis intact;reversible with intervention.  Stage 2: partial-thickness skin loss involving epidermis or dermis (or both); ulcer is superficial and presents clinically as an abrasion, blister or shallow crater.

6/22 Pressure ulcers were classified  Stage 3: full-thickness skin loss involving damage or necrosis of subcutaneous tissue that may extend down to, but not through, underlying fascia; ulcer presents clinically as a deep crater with or without undermining of adjacent tissue.  Stage 4: full-thickness skin loss with extensive destruction, tissue necrosis, or damage to muscle, bone or support structures (e.g. tendon, joint or capsule).

7/22 Data collection  On 6 June 1994, 18 northern New South Wales hospitals were visited and surveyed by the research team  Demographic information  description of the pressure ulcer  prevention and treatment interventions

8/22 Data analysis and results

9/22 Data analysis and results

10/22 Data analysis and results

11/22 Data analysis and results

12/22 Data analysis and results

13/22 Data analysis and results

14/22 DISCUSSION  This study was intended to illustrate both the prevalenceof pressure ulcers in addition to the variability in practicerelated to their prevention and treatment in hospitals innorthern New South Wales.

15/22 DISCUSSION

16/22 DISCUSSION

17/22 Prevalence  The total number 40 of a total of 634 patients overall prevalence of 6%.  Australian (5–14%)  worldwide studies(2–40%).  because of the inconsistencies in the reporting ofstage 1 pressure ulcers.

18/22 Patients  The majority of patients in this study presented withan admission diagnosis of respiratory, musculoskeletal, or problems classed in the other category

19/22 Pressure sores  The majority of pressureulcers examined (80%) were found on the heels, lowerspine and buttocks region and classed as either stage 1 or 2

20/22 Prevention and treatment  Thetreatment of pressure sores is also a diverse subject.  Reviews of the best evidence relating to pressuresore treatment have suggested that prior to any treatment,an assessment should be performed.  No hospital in thepresent study mentioned this first step as a component oftheir treatment protocol.

21/22 Prevention and treatment  The issue of pressure sores is an ongoing and costlyproblem  This study shows that hospitals in northern New South Wales are no exception. Until preventive and treatment measures for pressure sores are evaluated.pressure sores will continue to be a costly problem for health-care institutions.

22/22 謝謝聆聽指教