| Objectives:To construct a multidisciplinary cooperative evaluation and management plan for patients with pressure injury,in order to guide multidisciplinary teams to better evaluate and manage pressure injury,and improve the quality of life of patients with pressure injury.Methods:1.The literature research method is used for searching the guidelines in reference to the assessment and management of pressure injury from January 1,2010 to May 1,2020 in the guide website,professional association website and electronic database,and proceed in accordance with certain inclusion and exclusion criteria screen and use the guide quality evaluation tool AGREE Ⅱ to select high-quality guidelines.2.The expert letter inquiry method is adopted to conduct expert letter inquiry on the recommendations in the translated and integrated high-quality guidelines to form the first draft of recommendations of a multidisciplinary collaborative assessment and management for patients with pressure injuries.3.Using the questionnaire survey to evaluate the clinical applicability of the first draft of the guideline recommendations,to understand the current clinical development and whether the recommendations are suitable for clinical development at the current stage,combined with the interviews with stakeholders,to analyze the existing or potential obstacles in the pilot hospital application,according to the obstacles formulate corresponding action strategies,and construct a multidisciplinary collaborative assessment and management plan for patients with pressure injuries.Results:1.This study was initially included in 5 guidelines after systematic search and screening,and finally included in 3 clinical practice guidelines for Grade A pressure injury after quality evaluation,namely Prevention and Treatment of Pressure Ulcer/Injury:Clinical Practice Guidelines jointly published by National Pressure Injury Advisory Panel,European Pressure Ulcer Advisory Panel and Pan Pacific Pressure Injury Alliance in 2019,Wound,pressure ulcer and burn guidelines-2:Guidelines for the diagnosis and treatment of pressure ulcers,second edition issued by Japanese Dermatological Association in 2018.and Assessment and Management of Pressure Injuries for the Interprofessional Team Third Edition promulgated by Registered Nurses’Association of Ontario.Canada in 2016.2.147 recommendations were extracted from the 3 clinical practice guidelines for grade A pressure injury.65 recommendations were derived based on the principle of recommendation integration and expert opinions.3.After the 65 recommendations were evaluated for clinical applicability,the results showed that there are 34 items with ideal and maintain clinical status.20 items that are suitable for clinical development and optimization in the future,and 11 items that are not suitable for my country’s national conditions or clinical conditions are temporarily unsuitable for development.Through stakeholder interviews,it is found that the main obstacles are insufficient stakeholder support,lack of multidisciplinary cooperation assessment and management processes,and lack of relevant awareness and knowledge.Finally,the multidisciplinary cooperative evaluation and management plan for patients with pressure injury was constructed,including the knowledge manual of multidisciplinary cooperative assessment and management of patients with pressure injury,the health education guide manual for patients with pressure injury,the multidisciplinary collaborative assessment and management process for patients with pressure injury.Conclusions:1.3 foreign guidelines for pressure injury were included in this study.The guidelines are of good overall quality,and the recommendations of the guidelines are comprehensive,almost consistent,and of good applicability,which have reference value.2.The current status of the clinical practice of multidisciplinary cooperative assessment and management of s pressure injury in pilot hospitals is not optimistic,and there is still a certain gap with the recommendations of the guidelines.3.Refer to foreign high-quality guidelines,combined with domestic conditions and clinical scenarios,screen out recommendations suitable for pilot hospitals,and construct relevant documents for multidisciplinary evaluation and management of patients with pressure injury,which are scientific and practical.It provides medical staff,patients and their caregivers with reliable materials for guiding pressure injuries and learning about pressure injuries.In the future,it can guide and standardize the clinical practice of multidisciplinary teams to assess and manage pressure injury. |
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