BACKGROUND & AIMS:
:In Japan, long-term-care hospitals and facilities face the problem of quality of care, and providing adequate pressure ulcer care is one of the most urgent quality issues. Purpose of the present study was to explore the prevalence and incidence of pressure ulcers in long-term-care hospitals in Japan, and to identify factors associated with them. An anonymous questionnaire was sent to 720 randomly sampled, long-term-care hospitals all over Japan. The prevalence and incidence of pressure ulcers and their factors, including organizational strategies for pressure ulcer prevention and management, were examined. The mean prevalence and incidence of pressure ulcers was 9.6 and 1.9% per month, respectively. Almost all hospitals had established an interdisciplinary team for pressure ulcer prevention, developed a clinical protocol for pressure ulcers, and implemented education for staff. However, 35% of the interdisciplinary teams were not useful, more than half of the clinical protocols were not used frequently, and about half of the wards did not have sufficient pressure-relieving mattresses. In multiple regression analyses, a low prevalence of pressure ulcers was associated with a lower ratio of clients with a high medical severity level (p=0.034), the use of a clinical protocol including the management of preventive devices (p=0.023), the standardized pressure ulcer assessment tool (DESIGN-R; p=0.017), and staff education (p=0.003). This study demonstrated a higher prevalence and incidence of pressure ulcers in long-term-care hospitals in Japan as compared to regular acute-care hospitals, as well as poor organizational strategies for managing pressure ulcers.
背景与目标:
:在日本,长期护理医院和设施面临护理质量问题,提供足够的压疮治疗是最紧迫的质量问题之一。本研究的目的是探讨日本长期护理医院中压疮的患病率和发生率,并找出与之相关的因素。匿名调查表发送给了全日本720家随机抽样的长期护理医院。检查了压疮的患病率和发生率及其因素,包括预防和管理压疮的组织策略。压疮的平均患病率和发病率每月分别为9.6%和1.9%。几乎所有医院都建立了预防压疮的跨学科团队,制定了压疮临床方案,并对员工进行了教育。但是,35%的跨学科团队没有用,一半以上的临床方案不经常使用,并且大约一半的病房没有足够的减压床垫。在多元回归分析中,压疮的患病率较低与较高的医疗严重度水平的患者比例较低(p = 0.034),使用包括预防性装置管理的临床方案(p = 0.023),标准化的压疮评估工具(DESIGN-R; p = 0.017)和员工培训(p = 0.003)。这项研究表明,与常规的急性护理医院相比,日本的长期护理医院中压疮的患病率和发病率更高,而且管理压疮的组织策略较差。