Efficacy of Clinical Practice Guidelines for Prevention Pressure Injury in Risk Patients, Phayao Hospital

Abstract

Background: Pressure Injury is often a complication from illness especially patients with restriction in movement or bedridden cause suffering and longer hospital stay associated high cost. Delay in treatment, with subsequent severe complications, remains a cause of death in the management Pressure Injury. Objective: The aim of this study was to the efficacy of Clinical Practice Guidelines for Prevention Pressure Injury in Risk Patients, Phayao Hospital. Methods: This study was descriptive research in patients with Barden score ≤18admitted to the subintensive medicine ward, medical ward, orthopedic ward, female surgery ward and Sirikits private ward at Phayao hospital. Patients were divided into two groups: used the original practice between June 2016 and May 2017 and used the new practice from June 2017 to January 2018. Continuous variables were analyzed by Student’s t-test and assessed as mean with standard deviation. Differences in proportion were analyzed by Fisher’s exact test and assessed as count and percentage. A P-value ‹ 0.05 was considered statistically significant. Efficacy of Clinical Practice Guidelines for prevention Pressure Injury in risk patients was used to multivariable regression Poisson distribution model. Result: The study enrolled 439 patients with Barden score ≤18. Used the original practice was 274 patients Pressure Injury rate was 35.4% (n=97) and 165 new guidelines were applied, 20.0 % (n=33) pressure injury rate. Different clinical characteristics between the groups included patient group, diagnosis, Barden score, Diarrhea, Inserting the tube and drainage, on traction, Insertion the device prevention of Pressure Injury and length of hospital stay. The incidence of Pressure Injury per thousand days in patients used the new guidelines group less than used the original practice was 9.1 versus 21.0. After adjusted the differences of characteristics by statistical methods found that use of new practices decreased 45.0% (Rate ratio 0.55 95%CI 0.35- 0.89 p-value 0.014. Conclusion: The use of clinical guidelines for the prevention of Pressure Injury to reduce the incidence rate of Pressure Injury. Thus, should be using Clinical Practice Guidelines.