Investigation And Analysis Of Supervision System For Pressure Ulcers Management In The Facilities Of Shandong Province

Objectives Through the Investigation and analysis of supervision system for pressure ulcers management in some facilities of Shandong province, include the type of its organization, the responsibility of all levels, the regime of Pressure Ulcer risk assessment, report regime for pressure ulcers, the professional group of pressure ulcers and the pressure ulcers data collection, to provide references and suggestions for the future improvement of the system.Methods The research adopted simple sampling from September2013to October2013. A total of80tertiary-level facilities and171general secondary-level hospitals in Shandong province were investigated with a self-designed questionnaire on supervision system for pressure ulcers.251questionnaires were sent out, take back the valid questionnaire210cent, the effective recovery rate is83.67%.The questionnaire includes eight parts:①the hospital basic situation②supervision system for pressure ulcers③pressure ulcer risk assessment④the situation of pressure ulcers report⑤processing program of pressure ulcers⑥quality supervision of pressure ulcers⑦special nursing group for pressure ulcers⑧statistical data of pressure ulcers, the questionnaire includes80questions, using the form of choice and fill in. The questionnaire was sent and collected through the E-mail, we tell the people polled the purpose, the significance of research and how to fill the questionnaire by telephone. Data were calculated by SPSS17.0statistic software, database were established, double data entry, using descriptive analysis percentage, Fisher exact text, Chi-square test (P<0.05).Results1. There are157hospitals(74.76%)set up three-level quality control system and50hospitals (23.80%) set up two-level quality control system. The specific form of organization has more than10kinds according to every level responsibility subordinate different staff.2.There are120hospitals (57.14%) using Braden scales which is the most frequently used assessment tool. There are18hospitals (8.57%) using the assessment tool improved by themselves. There are100hospitals (49.52%) using Ⅵ stages grading the pressure ulcer.3.There are201hospitals having the standards for inevitable pressure ulcers,47hospitals (23.38%) only use assessment tool to define inevitable pressure ulcers while73hospitals (36.32%) don’t suing assessment tool defining it.4. The kinds of pressure ulcers reported are all the6stages pressure ulcer, inevitable pressure ulcers and hospital-acquired pressure. There200hospitals (95.23%) would verify the UP reported,and there are112hospitals (56%) limited24h.5. There are191hospitals evaluating the PU reported.158hospitals have the Special-trace table, the table mainly include wound situation, prognosis Site, stage, nursing measures and area.6.There are163hospitals (77.62%) having the regime of nursing consultation,120hospitals (73.62%) limited24h participated in consultation. The PU need to consult mainly are intractable PU (82.20%), inevitable PU (40.49%), high-risk and above PU (30.67%).Consultation personnel mainly are specialized consultation group (52.76%), pressure control group (53.99%).7. There are182hospitals (86.67%) having the regime of quality supervision of pressure ulcers.163hospitals(89.56%)have the standard of management problems,82 hospitals (45.05%) have the reward standard.8. There are154hospitals (73.33%) having the special nursing group for pressure ulcers. Its main duty are participating in consultation PU (93.51%), making treatment and curative effect (74.68%), tracking pressure ulcers reported (70.21%), monitoring clinical problems and puts forward the corresponding measures (64.94%).9. The average proportion of hospitals have various statistical data of PU is62.91%during the year of2012, and it is78.25%during the first half year of2013.10. There is significant difference between tertiary-level facilities and general secondary-level hospitals in the aspect of standards for inevitable pressure ulcers and nurse specialist (P<0.05)Conclusion1. The established ratio of supervision system for pressure ulcers management is as high as98.57%in Shandong province. The hospitals mainly use the three-level quality control system (74.76%),but different levels have different staffs, the forms of organization are very different,it’s is not conducive to set up nursing quality standard for PU.2. All the hospitals have the regime of PU risk assessment and classification, and have detailed provisions for evaluation and re-evaluation of PU. But the part of the hospital has not updated the knowledge. Risk assessment of special group was not taken seriously. The defined standards of inevitable PU need to be improved.3. More than90%of hospitals need to report and verify PU. But there is a greater difference in the report form.4. More than90%of hospitals have the regime of evaluating the PU reported, but they lack of uniform tracking standards due to the different report forms, there is little hospital using the pressure ulcer scale for healing.5. Most hospitals have special nursing group and nursing consultation of pressure ulcers. But the team construction is not reasonable. Professional training organization management is not perfect. It should be combined with the international situation and hospitals need to actively promote the development of specialty nursing.6. Most hospitals have the regime of quality supervision of pressure ulcers, but the management detail is not scientific and objective.7. On the whole Shandong province hospitals long-term lack of pressure ulcer correlation data statistics, so that it’s difficulties for the further studies.8. The general secondary-level hospitals need to improve the regime of standards for inevitable pressure ulcers and nurse specialist, and learn from the tertiary-level facilities.