The Application Of 4R Crisis Management Theory In Neonatal Non-invasive Ventilation Equipment Related Pressure Injury

ObjectiveTo understand the knowledge,attitude and behavior status of neonatal nurses on non-invasive ventilator-related pressure injury;4R crisis management theory,the use of noninvasive ventilation equipment of newborns skin management,discuss the in reducing neonatal non-invasive ventilation equipment related pressure injury incidence,improve skin injury severity and delay the occurrence time and shorten the damage to the skin return to normal status,the application effect of time,for the nursing staff to provide a scientific management mode.MethodsThe first part:Through literature review,a self-designed questionnaire was conducted to investigate 98 neonatal nursing staff from 6 hospitals in the city,so as to understand the knowledge,attitude and behavior status of nurses on neonatal pressure injury related to non-invasive ventilation equipment.The second part: 72 neonates admitted to the Neonatal Intensive Care Unit for non-invasive assisted ventilation from January 2019 to December 2019 were set as the control group,and 72 neonates admitted to the Neonatal Intensive Care Unit for non-invasive assisted ventilation from January 2020 to December 2020 were set as the observation group.The control group was treated with conventional skin management methods,while the observation group was treated with skin management based on 4R crisis management theory.The neonates receiving non-invasive assisted ventilation were treated with skin management in four stages: reduction,preparation,reaction and recovery.The incidence,time of formation,severity and recovery of skin injury.related to non-invasive ventilation equipment were observed in the two groups.ResultsThe first part:Nurses’ knowledge score of neonatal non-invasive ventilation equipment related pressure injury was(10.98±2.35),attitude score was(39.29±4.97)and behavior score was(8.73±2.79).The second part: There were 20 cases of non-invasive ventilators related pressure injury in the control group,the incidence was 28.17%,and 10 cases of the observation group,the incidence was 14.49%,which was lower than that in the control group,the difference was statistically significant(P < 0.05).There were 12 and8 cases of stage 1 and 2 non-invasive ventilation equipment related pressure injuries in the control group,and 8 and 2 cases of stage 1 and 2 non-invasive ventilation equipment related pressure injuries in the observation group,respectively,with no statistical significance(P > 0.05).The formation time of non-invasive ventilators related pressure injury in the control group was 1-3 days,with a median of 5 days,while the formation time of non-invasive ventilators related pressure injury in the observation group was 3-5 days,with a median of 3 days,with a statistically significant difference(P < 0.05).In terms of the time required for skin injury to return to normal skin state,the control group was 3-8 days,with a median of 3.5 days,while the observation group was 1-3 days,with a median of 2 days.The difference between the two groups was statistically significant(P < 0.05).The theoretical score and operational score of nurses before training were(73.78±12.31)and(67.39±7.05).After training,the theoretical test scores were(83.16±8.64)and the operational test scores were(82.03±3.84).Before and after training,the difference was statistically significant(P < 0.05).Conclusion1.Neonatal nurses have relatively insufficient knowledge of non-invasive ventilation equipment related pressure injury,positive attitude,behavioral ability urgently needs to be improved,it is necessary to strengthen the training of nurses on equipment related pressure injury,improve their cognitive level,and improve the quality of care.2.After relevant training,neonatal nurses have improved their theoretical and operational skills of non-invasive ventilator-related pressure injury,and their cognitive ability has been improved.3.Using 4R crisis management theory to manage the skin of newborns using non-invasive ventilation equipment can effectively improve the quality of skin management of children by nurses,reduce the incidence of non-invasive ventilation equipment related pressure injury,delay the formation time,and promote the recovery of skin injury after the occurrence of pressure injury.To form a set of continuous,systematic,dynamic and cyclical skin management mode.