ABSTRACT
Objective To investigate the effect of pressure ulcer risk warning system in the pressure ulcer management in patients undergoing thoracolumbar fracture surgery.Methods A retrospective case control study was performed to analyze the clinical data of 120 patients with thoracolumbar fracture who underwent posterior thoracolumbar pedicle screw fixation and intervertebral bone graft fusion surgery at People's Hospital of Henan Province from October 2016 to September 2018.There were 76 males and 44 females,aged 45-80 years [(59.2 ± 7.2) years].A total of 60 patients received treatment and care under the pressure ulcer early warning system (early warning group),while 60 patients were given assessment form for pressure ulcer management (control group).The time of filling in the assessment form,the implementation score of pressure ulcer prevention measures,the incidence of pressure ulcer,visual analogue pain score (VAS) and patient satisfaction were compared between the two groups.Results In the control group and early warning group,the time of filling in the form was (121.5 ± 9.0) minutes and (11.3 ± 2.0) minutes (P ＜ 0.01),the implementation score of pressure ulcer prevention measures was (85.9 ± 3.8) points and (96.0 ± 2.2)points (P ＜ 0.01),and the pressure ulcer incidence was 25％ (15 patients) and 3％ (two patients),respectively (P ＜0.01).In the control group,the preoperative VAS was (7.3 ± 1.3) points,and the VAS at 6 hours,24 hours,48 hours,72 hours after operation were (3.7 ± 1.1) points,(3.2 ± 0.9) points,(2.4 ± 1.0) points,(2.3 ± 0.8) points,respectively.In the early warning group,the preoperative VAS was (7.4 ± 1.3) points,and the VAS at 6 hours,24 hours,48 hours,72 hours after operation were (2.9 ± 0.7) points,(2.4 ± 0.7) points,(1.8 ± 0.7) points,(1.6 ± 0.8) points,respectively.There was no significant difference in preoperative VAS between the two groups (P ＞ 0.05),while significant differences were found between the postoperative VAS (P ＜ 0.01).The satisfaction score in the control group was (94.6 ± 1.4) points,while that of the early warning group was (98.3 ± 1.1) points (P ＜ 0.01).Conclusion For patients undergoing posterior thoracolumbar pedicle screw fixation and intervertebral bone graft fusion surgery,the pressure ulcer risk warning system is convenient and reduces the incidence of pressure ulcer,thus alleviating patients'pain and improving patients' satisfaction.
ABSTRACT
Objective To explore the reporting process of our health risk warning system and its long-term effectiveness.Methods A total of 1 168 individuals who were identified as higher risk populations from July 2011 to June 2012 in our Health Mangement Center were served as the control group,and another 973 adults who were identified as higher risk individuals from July 2012 to May 2013 were assigned to the study group.Diagnosis and treatment were based on our health risk reporting process and follow-up system.Paired t test and paired contingency table x2 test were used for data analysis.Results The rate of follow-up (97％ vs 100％,x2=30.503,P＜0.05),consultation (83.48％ vs 93.63％,x2=52.142,P＜ 0.05),mean treatment time ((3.0±0.5) vs (1.5±0.5) d,t=69.12,P＜0.05) and patient satisfaction (87.84％ vs 96.20％,x2=48.361,P＜0.05) were significantly different between the two groups,although no statistically significant difference of incidence of adverse events was found (0.26％ vs 0.10％,x2 =0.102,P＞0.05).Conclusion Our health risk warning system may reduce the time for physical examination and improve disease diagnosis level and patients' satisfaction.Moreover,our health manatement system and health service quality should further be improved in practice.