Design And Application Study Of Dressing Checklist For Pressure Injury

Objective:To construct a nurse-led dressing checklist for PI(pressure injury),and to explore the effect of dressing checklist on wound healing,pain level and nutritional status of inpatients with pressure injury,so as to standardize the form of dressing for nurses.to provide a new and standard procedure for nurses to dressing in general wards.Methods:In the first stage,the dressing checklist was constructed:an evidence-based group was set up to find the best evidence of pressure injury by searching the relevant literature at home and abroad.Johns Hopkins literature quality evaluation method was used to summarize the literature evidence and establish the list items.JBI evidence classification method was used to evaluate and grade the evidence.Combined with the method of expert meeting,the dressing checklist of pressure injury was constructed.In the second stage,the application of pressure injury dressing checklist:in this study,convenient sampling method was used to select patients with pressure injury who were treated in a Grade 3A Hospital in Nanchang City,Jiangxi Province from June 2021 to February 2022 as the object of study.Patients who met the inclusion criteria from June 2021 to September 2021 were taken as the control group,and the conventional dressing method was used to dressing.The patients who met the inclusion criteria from October 2021 to January 2022 were treated as the experimental group,using the pressure injury dressing checklist for dressing.general data questionnaire,pressure injury wound healing scale,visual simulation score,wound evaluation triangle evaluation,subjective comprehensive evaluation and self-made patient satisfaction score were used.The patients were investigated and evaluated before dressing,1 week after dressing,2 weeks after dressing and 3 weeks after dressing.SPSS23.0 software was used to analyze the data,and the statistical methods included independent sample t-test,Mann Whitney U test,chi-square test,generalized estimation equation analysis and Marginal Homogeneity test.Results:1.Through retrieval,a total of 11 pieces of evidence were screened,including 4guides,1 best practice information book,3 systematic reviews and 3 expert consensus.Finally,54 pieces of best evidence were summarized.By refining the best evidence and combining with expert opinions,the PI dressing checklist was finally drawn up,which included evaluation and measurement,pain management,wound and edge debridement,dressing selection and health education.2.In this study,after 3 weeks of intervention,the healing rates of the test group and the control group were 100.00(79.71,100.00)and 71.43(43.75,100.00),respectively.The wound healing rates of patients with stage 3 and above PI in the test group and the control group were 76.00(60.00,100.00)and 40.84(26.98,52.78)respectively,and there was significant difference between the two groups(Z=3.175,P<0.01).3.In this study,the wound healing scores of the experimental group before,1 week,2 weeks and 3 weeks after intervention were 11.00(9.00,13.00),9.00(5.75,11.25),5.00(0.00,9.25)and 0.00(0.00,7.25)respectively.The wound healing scores of the control group before intervention,1 week after intervention,2 weeks after intervention and 3 weeks after intervention were 10.00(5.00,13.00),10.00(5.00,13.00),9.00(0.00,12.00),0.00(0.00,12.00)respectively.The results of generalized estimation equation analysis showed that there were significant differences in intra-group,inter-group and interactive effects of wound healing score,area dimension score and exudation dimension score(Waldχ~2=11.792,9.732,14.388,P<0.05 respectively).There was no significant difference in the score of wound tissue type between groups(Waldχ~2=0.292,P>0.05),but there were significant differences in intra-group and interaction effects(Waldχ~2=32.292,9.165,P<0.05respectively).4.In this study,the pain scores of the experimental group before intervention,1week after intervention,2 weeks after intervention and 3 weeks after intervention were4.00(3.00,5.00),3.00(2.00,4.00),0.50(0.00,0.25)and 0.00(0.00,1.25)respectively.The pain scores of the control group before intervention,1 week after intervention,2weeks after intervention and 3 weeks after intervention were 4.00(3.00,5.00),4.00(3.00,6.00),3.00(0.00,5.00)and 2.00(0.00,4.00)respectively.The results of generalized estimation equation analysis showed that there were significant differences in pain scores within groups,between groups and interaction effects(Waldχ~2 values were 91.136,26.615 and 9.760,respectively,P<0.05).5.In this study,there was no significant difference in the number of patients with different nutritional status between the two groups before intervention(χ~2:1.489,P>0.05),but there was significant difference between the two groups after intervention(P<0.01).There was significant difference in the experimental group before and after intervention(Z=1.990 P<0.05),but there was no significant difference in the control group before and after intervention(Z=1.134 P>0.05).Conclusion:The dressing checklist for PI is comprehensive and has strong clinical maneuverability.The pressure injury dressing list effectively promotes the wound healing of pressure injury,reduces the pain associated with changing dressing, improves the nutritional conditions of patients,improves the satisfaction of patients and nurses.