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Documentare la gestione del wound-care: quali ripercussioni sugli outcome assistenziali

Jacopo Fiorini, Giulia Venturini, Guido Scotti, Roberto Cresta, Roberto Latina, Alessandro Sili

Abstract

Scopo: Valutare la gestione del wound-care all’interno di un Policlinico di Roma.

Metodo: Studio osservazionale, diviso in due fasi, attraverso l’analisi di 301 cartelle infermieristiche di pazienti ricoverati presso il Policlinico con lesioni da pressione già in atto o sviluppate successivamente al ricovero. 151 sono state analizzate direttamente nei reparti di degenza nel biennio 2013-2014. 150 sono state reperite in versione digitale e si riferiscono al triennio 2010-2012.

Risultati: La documentazione infermieristica relativa alle lesioni da pressione risulta completa, come da protocollo ospedaliero, mediamente nel 4%. Le schede Push Tool e Braden sono presenti nelle cartelle rispettivamente nel 6% e nell’86% di quelle esaminate. Le medicazioni sono svolte correttamente nell’80% dei casi. L’outcome clinico risulta nel 68% dei casi stabile e nel 13% si registra un miglioramento.

Conclusioni: Lo studio ha evidenziato un incremento della documentazione, pur non risultando completa a causa dell’assenza della scheda Push Tool. Si registra un miglioramento dell’outcome clinico nei cinque anni e una maggiore appropriatezza nel trattamento delle lesioni. Tuttavia, si sottolinea la necessità di incrementare corsi di formazione sulle lesioni da pressione.

Parole chiave: Lesione da pressione, wound-care, Nursing care, documentazione, Patient Outcome Assessment

 

Wound Care Management: impact on outcomes of nursing care

Aim: To evaluate wound care management in Rome’s Hospital.

Method: Observational study, divided into phases, through the analysis of 301 nursing records of patients either admitted to the hospital with ulcer pressure at the admission or grown later. Among the nursing records, 151 have been analyzed directly in the wards and 150 are referred to the triennium 2010-2012 and have been traced in a computerized version.

Results: The nursing records concerning the ulcer pressure is completed in 4% average. The Push Tool and Braden scale are respectively present in 6% and 86% of the nursing records analyzed. The treatment are correct in the 80% of the cases. The clinic outcome is stable in 68% of the cases and in the 13% is registered an enhancement.

Conclusions: The study underlined an increase of the nursing documentation, although not completed caused by the absence of the Push Tool scale. It has been registered an enhancement of the clinic outcome in the five years and a better pertinence in the treatment of the ulcers pressure. However is evident the necessity of increasing education courses on the ulcers pressure.

Key words: Pressure Ulcer, wound-care, nursing care, documentation, Patient Outcome Assessment

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