Knowledge and Interventional Behaviors of Nurses on Pressure Ulcer Care

Abstract

本研究目的在探討中部醫學中心、區域及地區醫院三家之成人內、外科病房及加護病 房護理人員在壓瘡傷口照護的認識、執行及相關因素。以自擬結構式問卷收集資料， 共得248份有效問卷。研究結果發現：護理人員在壓瘡傷口照護知識的平均答對率僅 有44.7%。年齡大於25歲、大學以上學歷、工作年資5年以上、任職醫學中心或區域醫 院及最近一年曾經參加壓瘡傷口照護相關課程者，對壓瘡傷口照護有較好的認識。在 清潔劑與消毒劑的使用方面，護理人員經常以優碘消毒無感染跡象的壓瘡傷口，較少 以生理食鹽水清潔壓瘡傷口；針對無壞死組織、非感染及少量滲液之第二級壓瘡傷口 的敷料使用方面，以將傷口暴露在空氣中、乾紗布覆蓋或噴灑粉狀製劑之執行頻率多 於採行可以維持傷口濕潤的生理食鹽水紗布濕敷、薄膜或親水性敷料。護理人員的年 齡、工作年資、醫院層級、最近一年是否研讀壓瘡傷口照護相關文獻在壓瘡傷口照護 行為上有顯著差異。護理人員在清潔劑與消毒劑、按摩、氣墊圈及烤燈的知識與使用 優碘、按摩、氣墊圈及烤燈的執行頻率呈負相關。本研究結果可作為編寫壓瘡傷口照 護教材、規劃在職教育與病房政策及請領照護醫材之參考，以增進壓瘡傷口的照護品 質。 The purpose of this study was to investigate the knowledge and interventional behavior of nurses with respect to pressure ulcer care. This descriptive survey study was carried out in a medical center, a regional hospital and a local hospital in Taichung, Taiwan. A cross- section research design with purposive sampling was adopted. Two hundred and forty eight RNs from medical wards, surgical wards and adult ICUs were enrolled. They filled out a set of questionnaires developed by the researchers regarding knowledge and interventional behavior on pressure ulcer care . The results showed that the mean correct rate of the nurses on knowledge of pressure ulcer care was 44.7%. A higher knowledge score was found for nurses who: (1) were older than 25 years old, (2) had a bachelor or master degree , (3) had work experience of more than 5 years in a medical center or regional hospital, and (4) had attended classes concerning pressure ulcer care within the previous years. Nurses usually cleaned uninfected pressure ulcer with povidone-iodine instead of with normal saline (mean performance rate: 75.0% vs.34.2%). In non-non-necrotic and uninfected pressure ulcers with small amount exudates, nurses selected to“expose wound to the air” , “apply gauze or powder” more often than to apply “wet dressings”, “film” or “hydrocolloid dressings” . The significant factors influencing the nurses’ interventional behavior for pressure ulcer care were: age, work experience , the level of the hospitals, a nurses’ private study and materials/ equipment available in the unit. The knowledge score of the nurses on disinfectants, massage, donut cushions and heat light had negative correlations with the performance rate on applying povidone-iodine, massage, donut cushions and heat light usage. The information provided by this study can serve as a good reference for the editing textbooks, the planning of school/on-job education, for the making of policy and for decisions concerning the equipping of a unit with materials for pressure ulcer care.