| [Objective] ①To construct research tool of skin tears suitable for Chinese current situation using Delphi method. ②We implement a multi-center cross-sectional study of hospitalized patients with skin tears prevalence, distribution, risk factors and preventive care measures in order to provide evidence for the clinical frontline nurses to screen high-risk groups, continuous dynamic monitoring of quality skin care and take appropriate preventive care measures.[Method] ①The primary version of indicator system of research tool about skin tears is developed through literature review and data integration.We select the 26 senior title specialists in wound ostomy incontinence care from 11 provinces and 18 cities to conduct 3 round of consultation. We modify the index of research tool according to amendments made by the experts, and verify the content validity of the tool according to analyze positive coefficient, authority coefficient and the level of coordination (described by the index coefficient of variation);We conduct a pilot study through choosing a grade A tertiary hospital in Nanjing to verify the reliability and feasibility of the tool. ②We train 1017 nurses and conduct a cross-sectional study to 19,010 hospitalized patients from a tertiary hospital of nine provinces and eleven cities using the constructed tool.We preliminary get the prevalence, distribution, risk factors and preventive care measures of skin tears about the inpatients of our country.[Result] ①Results of Delphi method:We develop the four first-level indicators and 26 secondary indicators of research tool consisting of general information, disease information, observations skin, preventive care measures according to three expert advice and feedback about the indicators.The positive coefficient are all 100% and the authoritative coefficient are all 0.84 of the three rounds, and the each index variation coefficient is 0.16-0.63,0.12-0.52,0.08-0.27 respectively.②Results of the pilot in a grade A tertiary hospital:The total Cronbacha coefficient of Braden Scale is 0.86,the range of Cronbacha coefficient in different wards is 0.80 0.90.The practive evaluation rate was 94.05% and the convenience evaluation rate is 93.58%;the completion of each survey at an average of 5.96±3.31min.②The examination results of Senate inquiry nurse:the nursing age is range of 2 to 33 years,and the average nursing age is 10.58±6.41.The average score is 91.79±5.33, and score≥85 points is 963 people,with a pass rate of 94.69%;⊙Results of the multi-center cross-sectional survey:Totally 19010 questionnaires are issued, and 18,806 valid questionnaires are obtained at last,efficiency is 98.93%;The survey found a total of 199 cases occurred skin tears with 238 locations, the prevalence is 1.06%. Distribution of patients with skin tears:according to STAR rating system based on international expert advisory group, the most common category is category 3 with 116 locations(48.74%),the most common occurrence site is the upper limbs with 83 locations (34.87%),The male prevalence (1.49%) was more than women (0.55%),the difference is statistically significant (P<0.05);The highest prevalence is in ICU up to 6.42%, prevalence between different wards is statistically significant (P <0.05);Three main reasons of skin tears are falling (28.99%), blunt force trauma (23.11%), and medical adhesive dressing (19.75%);The number of skin tears patients without any preventive care measures in 199 cases accounting for 51.76 percent,and the rat of implement is more than 50% with only two nursing measures;Risk factors of skin tears:male,aged,low activity, malnutrition, friction and shear, low protein,history of skin tears(P<0.05).[Conclusion] ①Te status research tool of skin tears has good reliability and validity, and the feasibility is high and simple operation, suitable for hospitalized patients in our country,and it can provide evaluation tools for intervention of skin tears in hospitalized patients②The study shows skintears prevalence is 1.06%,are hospital acquired;The prevalence in men is more than women, and it increases with age;the highest prevalence of three types of ward is in the ICU,department of Neurology,Geriatrics;The most common classification is category 3,and the most common sites are upper limbs;The three most common reasons are falling, blunt force trauma and removal of medical adhesive dressings;Risk factor of skin tears are male,aged,low activity,malnutrition,friction and shear,low protein,history of skin tears,no-aids. |
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