文档介绍：压疮护理 101 Pressure Wound Care 101 Sharon Lepper 护理学学士,注册护士, 伤口造口失禁护士 Sharon Lepper BSN RN Copyright EHOB, 2010 EHOB 产品由上海天呈“医流商城”全国代理, 招商加盟热线:021-51083677-869 手机: ********** 谢秋亭传真: 51816400 , 地址:上海市杨浦区翔殷路 128 号国家大学科技园 1号楼 B座310 室。 Copyright EHOB, 2010 2 预案能够使压疮发病率降低 50% Protocols decrease incidence by 50% 1 1. 书名:《护理人员的培训影响老年住院病人的褥疮发生》内科学文献 1988; 148:2241- 2243. 作者: Moody BL, Fanale JE, Thompson M. Vaillancourt D, Symonds G, Bonasoro C. 1. Moody BL, Fanale JE, Thompson M. Vaillancourt D, Symonds G, Bonasoro C. Impact of staff education on pressure sore development in elderly hospitalized patients. Archives of Internal Medicine. 1988; 148:2241-2243. Copyright EHOB, 2010 Copyright EHOB, 2010 3 压疮的临床预案应解决以下方面: Clinical Protocols for Pressure Ulcers Should Address: Cognition 认知 Mobilization & Ambulation 活动与步行 Nutrition and Hydration 营养和水化 Moisture and Incontinence 湿度和失禁 Medication Use 药物治疗 Existing Pressure Ulcers (Deep Tissue Injury )已生成的褥疮(深部组织损伤) Contact with medical devices (., braces, orthothics, cannulas, tubing), and/or any object in contact with the body 接触医疗器械(例如,支架、矫形器、插管、输液管)和/或任何与身体接触的物体) Copyright EHOB, 2010 Copyright EHOB, 2010 4 4 4 ALL SUPPORT SURFACES SHOULD : 所有的支持表面应具备以下几点: Redistribute weight in a 3-dimensional manner. 以三维方式重新分配体重 Minimize pressure, shear and friction injury. 使压力、剪切力和摩擦损伤最小化 Assist in moisture and temperature control. 协助控制湿度和温度 Be easy to clean. 易于清洁 Aid in patient transferring and mobilization. 辅助患者的转移和活动 Be cost effective. 性价比高为什么要遵循临床预案? Why Follow Protocols? Copyright EHOB, 2010 Copyright EHOB, 2010 5 5 55 ALL LOWER EXTREMITY PROTOCOLS SHOULD: 所有的下肢预案都应具备: Elevate heel (Dewedge). 提高足跟 Protect side of foot and ankle. 保护脚侧和脚踝 Neutralize weight of lower extremity (Delever). 冲减下肢重量 Maintain and promote circulation. 保持和促进血液循环 Address foot drop and lateral rotation of the ankle. 改善足下垂和踝关节外侧旋转 Allow access to the foot for inspection/treatment as well as range of motion techniques. 允许进到足部进行检查/治疗,以及各种运动技巧 Be li