Evidence-Based Nursing Practice of Best Turning Over Strategy for a Patient with the Risk of Pressure Ulcer_Chinese Journal of Evidence-Based Medicine

Authors：

YIN Min ,  LI Xiaolin

Nursing College, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

LI Xiaolin, Email: qling100@163.com

Keywords：

Pressure ulcer; Prevention; Turn over; Evidence-based nursing

DOI：

10.7507/1672-2531.20130137

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective 　To formulate an evidence-based nursing strategy of turning over for a patient with the risk of pressure ulcer.
Methods 　The personalized clinical questions were put forward based on the PICO and patient’s condition, and the following databases such as NGC, The Cochrane Library of DARE, CDSR, CCTR, MEDLINE, PubMed and CBM were searched to collect the best clinical evidences of turning over for preventing pressure ulcer.
Results 　One clinical guideline, one systematic review and three randomized controlled trials were included finally. According to the retrieval outcomes, patient’s clinical condition, and patients and their family members’ willingness, a reasonable nursing plan of turning over was formulated: lie on the visco-elastic foam decompression bed, turn over every 4 hours, and combine supine position with alternation of left-oblique 30° position and right-oblique 30° position. During hospitalization, the grade-I pressure ulcer in size of 4×6 cm2 on patient’s sacrococcygeal region was clear, dry and not broken, and the other part of body with pigmentation had no occurrence of pressure ulcer.
Conclusion 　Evidence-based approaches are helpful to provide patient with a nursing plan that meets the needs of both scientificalness and individualization.

Citation： YIN Min,LI Xiaolin. Evidence-Based Nursing Practice of Best Turning Over Strategy for a Patient with the Risk of Pressure Ulcer. Chinese Journal of Evidence-Based Medicine, 2013, 13(6): 773-776. doi: 10.7507/1672-2531.20130137 Copy

1.	王维平, 邓哲, 陈锡林. 波浪床预防压力性溃疡的临床研究. 中华物理医学与康复杂志, 2005, 27(7): 425-427.
2.	Reddy M, Sudeep SG, Paula AR. Preventing Pressure Ulcers: A Systematic Review. JAMA, 2006, 296(8): 974-984.
3.	Hagisawa S, Ferguson-Pell M. Evidence supporting the use of two-hourly turning for pressure ulcer prevention. J Tissue Viability, 2008, 17: 76-81.
4.	Cullum N, Deeks J, Fletcher A, et al. The Prevention and Treatment of Pressure Sores. Effect Heal Care, 1995, 2(1): 1-18.
5.	Moore ZEH, Cowman S. Repositioning for treating pressure ulcers (Review). Cochrane Database of Systematic Reviews 2009, Issue 2. [Art. No.: CD006898. DOI: 10.1002/14651858.CD006898.pub2].
6.	高晓阳, 李瑛. 有关翻身时间的循征护理研究. 齐齐哈尔医学院学报, 2008, 29(23): 2927-2928.
7.	林岩, 镇艳, 潘丽芬, 等. 适时翻身替代定时翻身预防临终癌症患者压疮的探讨. 护理学报, 2007, 14(1): 87-89.
8.	邵培双, 胡宝芹, 金彩霞. 改变侧卧度数预防早期压疮效果观察. 护理学杂志, 2008, 23(7): 20-21.
9.	蒋琪霞. 压疮预防护理中存在的问题分析及对策研究进展. 中华现代护理杂志, 2010, 16(7): 855-857.
10.	喻投花, 乐革芬, 黄海燕. 外科压疮高危患者的循证护理. 护理学杂志, 2009, 24(8): 4-5.
11.	魏红, 刘月梅, 李淑霞. 昏迷患者使用喷气式褥疮垫翻身时间探讨. 中国康复理论与实践, 2005, 11(8): 665-666.
12.	邓可刚. 循证医学证据的检索步骤与检索系统的选择. 中国循证医学杂志, 2004, 4(9): 634-637.
13.	National Pressure Ulcer Advisory Panel. Pressure ulcer prevention recommendations. In: pressure ulcers: clinical practice guideline.Washington (DC): National Pressure Ulcer Advisory Panel, 2009.
14.	Lee AK, Mikel G. Does Regular Repositioning Prevent Pressure Ulcers. J Wound Ostomy Continence Nurs, 2008, 35(6): 571-577.
15.	Defloor T, Bacquer DD, Maria HF, et al. The effect of various combinations of turning and pressure reducing devices on the incidence of pressure ulcers. International J Nurs Stud, 2005, 42(1): 37-46.
16.	Vanderwee K, Grypdonck MHF, Bacquer D, et al. Effectiveness of turning with unequal time intervals on the incidence of pressure ulcer lesions. J Adv Nurs, 2006, 57(1), 59-68.
17.	Moor Z, Cowman S, Conroy RM. A randomized controlled clinical trial of repositioning, using the 30° tilt, for the prevention of pressure ulcers. J Clin Nurs, 2011, 20(17): 2633-2644.
18.	刘鸣. 应正确评价和使用循证医学证据. 中国循证医学杂志, 2006, 6(2): 77-79.
19.	李幼平. 循证医学. 2版. 北京: 高等教育出版社, 2009.
20.	谢少清, 牛娟, 童风玲, 等. Braden压疮危险因素评分表预测压疮的研究进展. 中华现代护理杂志, 2009, 15(30): 3209-3211.
21.	刘顶, 陈赛莲. 压疮高危患者使用气垫床翻身时间的研究. 中国当代医药, 2012, 19(13): 117-119.

1. 王维平, 邓哲, 陈锡林. 波浪床预防压力性溃疡的临床研究. 中华物理医学与康复杂志, 2005, 27(7): 425-427.
2. Reddy M, Sudeep SG, Paula AR. Preventing Pressure Ulcers: A Systematic Review. JAMA, 2006, 296(8): 974-984.
3. Hagisawa S, Ferguson-Pell M. Evidence supporting the use of two-hourly turning for pressure ulcer prevention. J Tissue Viability, 2008, 17: 76-81.
4. Cullum N, Deeks J, Fletcher A, et al. The Prevention and Treatment of Pressure Sores. Effect Heal Care, 1995, 2(1): 1-18.
5. Moore ZEH, Cowman S. Repositioning for treating pressure ulcers (Review). Cochrane Database of Systematic Reviews 2009, Issue 2. [Art. No.: CD006898. DOI: 10.1002/14651858.CD006898.pub2].
6. 高晓阳, 李瑛. 有关翻身时间的循征护理研究. 齐齐哈尔医学院学报, 2008, 29(23): 2927-2928.
7. 林岩, 镇艳, 潘丽芬, 等. 适时翻身替代定时翻身预防临终癌症患者压疮的探讨. 护理学报, 2007, 14(1): 87-89.
8. 邵培双, 胡宝芹, 金彩霞. 改变侧卧度数预防早期压疮效果观察. 护理学杂志, 2008, 23(7): 20-21.
9. 蒋琪霞. 压疮预防护理中存在的问题分析及对策研究进展. 中华现代护理杂志, 2010, 16(7): 855-857.
10. 喻投花, 乐革芬, 黄海燕. 外科压疮高危患者的循证护理. 护理学杂志, 2009, 24(8): 4-5.
11. 魏红, 刘月梅, 李淑霞. 昏迷患者使用喷气式褥疮垫翻身时间探讨. 中国康复理论与实践, 2005, 11(8): 665-666.
12. 邓可刚. 循证医学证据的检索步骤与检索系统的选择. 中国循证医学杂志, 2004, 4(9): 634-637.
13. National Pressure Ulcer Advisory Panel. Pressure ulcer prevention recommendations. In: pressure ulcers: clinical practice guideline.Washington (DC): National Pressure Ulcer Advisory Panel, 2009.
14. Lee AK, Mikel G. Does Regular Repositioning Prevent Pressure Ulcers. J Wound Ostomy Continence Nurs, 2008, 35(6): 571-577.
15. Defloor T, Bacquer DD, Maria HF, et al. The effect of various combinations of turning and pressure reducing devices on the incidence of pressure ulcers. International J Nurs Stud, 2005, 42(1): 37-46.
16. Vanderwee K, Grypdonck MHF, Bacquer D, et al. Effectiveness of turning with unequal time intervals on the incidence of pressure ulcer lesions. J Adv Nurs, 2006, 57(1), 59-68.
17. Moor Z, Cowman S, Conroy RM. A randomized controlled clinical trial of repositioning, using the 30° tilt, for the prevention of pressure ulcers. J Clin Nurs, 2011, 20(17): 2633-2644.
18. 刘鸣. 应正确评价和使用循证医学证据. 中国循证医学杂志, 2006, 6(2): 77-79.
19. 李幼平. 循证医学. 2版. 北京: 高等教育出版社, 2009.
20. 谢少清, 牛娟, 童风玲, 等. Braden压疮危险因素评分表预测压疮的研究进展. 中华现代护理杂志, 2009, 15(30): 3209-3211.
21. 刘顶, 陈赛莲. 压疮高危患者使用气垫床翻身时间的研究. 中国当代医药, 2012, 19(13): 117-119.

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