Research On The Application Of Multidisciplinary Collaborative Model Leaded By Specialized Nurses In ICU Pressure Ulcer Prevention And Control

Objective:Screening for ICU patients through Braden Pressure ulcer Risk Assessment Scale,analyzing and exploring the main risk factors for pressure ulcers and suggesting prevention strategies;conducting multi-disciplinary consultations for patients with pressure ulcers,formulating standardized,personalized and continuous Treatment and nursing measures to reduce the occurrence of ICU-acquired pressure ulcers and improve the quality of care.Methods:The study subjects were 140 patients admitted to the ICU of our hospital from July 2016 to June 2017 and met the inclusion criteria,and the ICU nurses who took care of them.The patients were grouped according to time,The patients admitted from July to December 2016 were the control group,and the patients from January to June in 2017 were intervention groups,70 patients in each group.The control group used the traditional pressure ulcer prevention treatment mode,the intervention group surveyed 30 ICU nurses for the “Clinic Questionnaire on Prevention of Pressure ulcer Prevention Knowledge and Skills of ICU Nurses” before the study;A multidisciplinary team(MDT)led by international ostomy therapists,which a total of 8 core team members from specialist doctors in ICU,surgery,infections,and dieticians,ICU head nurses and wound contact group;trained ICU nurses to master the knowledge of pressure ulcer prevention,increase the emphasis on high-risk patients with pressure ulcers,and enhance the ability to prevent preventive nursing behavior;through monitoring the key indicators of the pressure ulcer occurrence of 70 patients with high risk of pressure ulcers(11 patients carrying more than one pressure ulcer,accounting for 15.7%),formulate and implement individualized treatment and prevention measures,collaborate and guide to solve difficult nursing problems and optimize treatment solutions by MDT.After 6 months of practice,the changes of related indicators were evaluated before and after intervention.Results:1.The theory and skills of ICU nurse pressure ulcers were jointly trained by surgeons,stoma therapists,and dietitians for 4 weeks.After the training,the survey results showed that 30 ICU nurses had higher questionnaire scores than before training(P<0.05),basically mastered the causes and common parts of pressure ulcers,correctly used risk assessment scales,posture management techniques and other knowledge,actively participated in nursing,made early prevention,improved the predictive nursing capacity of pressure ulcers,and increased confidence in the prevention and treatment of pressure ulcers.2.9 patients withdrew from the study during the study period,including 5 in the control group and 4 in the intervention group.Among the 131 ICU patients,19(14.5%)had caught hospitalpressure ulcers.The incidence of pressure ulcers in the control group was significantly higher than that in the intervention group(P<0.05).3.Comparison of the outcomes of wounds in patients with pressure ulcers: Control group: among 9 patients with pressure ulcer,1 patients with stage 1 pressure ulcer(11.1%),3 patients with stage 2 pressure ulcer(33.3%),3 patients with stage 3 pressure ulcer(33.3%),2 patients with stage 4 pressure ulcer(22.2%).Pressure ulcers occur in the sacrococcygeal,heel,scapula,hip,and lateral malleolus.Intervention group: among 11 patients with pressure,1 patients with stage 1 pressure ulcer(9.1%),3 patients with stage 2 pressure ulcer(27.3%),4 patients with stage 3 pressure ulcer(36.3%),and 3 patients with stage 4 pressure ulcer(27.3%).Pressure ulcers occur in thesacrococcygeal,heel,hip,lateral malleolus,and posterior occipital.in the control group,1 patients healed and 3 patients aggravated;in the intervention group,5 patients healed and nopatients aggravated(P<0.05).Conclusions:The medical and nursing integrated wound management model is one form of advanced nursing clinical practice in a multidisciplinary cooperative team.The international ostomy therapists provide personalized,standardized,and continuous management of pressure ulcers for critically ill patients with their knowledge and skills.which can significantly reduce the occurrence of pressure ulcers in hospitals and effectively improve the overall nursing ability of the ICU nursing team to predict the occurrence of pressure ulcerpatients.