目的 遴选并获取预防医疗器械相关压力性损伤的临床实践依据,并对相关证据进行总结。方法 针对医疗器械相关压力性损伤提出问题,检索国内外数据库相关文献,检索时限为建库至2019年10月。由2名研究者依据JBI循证卫生保健中心的文献评价标准和证据分级系统,对各类研究进行文献质量评价及证据级别评定,纳入符合质量标准的文献,并提取证据。 结果 共纳入证据8篇,包括指南6篇、专家共识1篇、系统评价1篇。最终形成包括皮肤评估、皮肤清洁、医疗器械的安置与移动、合理使用敷料和教育培训5个方面的最佳证据。 结论 本研究总结了预防医疗器械相关压力性损伤的临床实践依据,在临床应用证据时,建议评估相关医疗机构的就医环境、设备条件及医护人员应用证据时的促进及阻碍因素、患者意愿等因素,筛选调适后,进行有针对性的证据使用,以促进证据有效地向临床转化,为临床护理实践提供更多科学依据,从而提升护理质量。

Objective To collect and summarize the evidence based clinical practice of medical device related pressure injury prevention. Methods We searched related studies regarding the prevention of medical device related pressure injury in main databases from inception to October 2019. Two investigators evaluated the quality of the included literatures by using the literature evaluation criteria and evidence classification system of the Joanna Briggs Institute and extracted evidences from documents that met the inclusion criteria. Results A total of 8 articles were included with 6 guidelines,1 expert consensus,and 1 systematic review. The best evidence included skin assessment,skin cleaning,placement and movement of medical devices,rational use of dressings,and education and training. Conclusion This study summarizes the evidence based clinical practice for preventing medical device related pressure injury by searching databases at home and abroad. It is suggested that evidence users should select best evidence with consideration of hospital characteristics,clinical settings,promoting and hindering factors by medical staffs and the willingness of patients. The study can provide more evidence for clinical practice so as to improve the quality of nursing.