論文詳細
敬心・研究ジャーナル第２巻 第２号
介護老人保健施設での包括的褥瘡ケアシステムによる褥瘡発生減少への取り組み
―OHスケール（芦名版）のリスク度別褥瘡発生率、再発率、発生部位の検討―
小武海将史1）
小田桐峻公1）
奥壽郎2）
２）大阪人間科学大学 人間科学部 理学療法学科
抄録
【目的】介護老人保健施設における褥瘡発生を減少させる為に褥瘡発生者の特徴を、OHスケール（芦名版）をもとに褥瘡発生リスク評価と再発率および発生部位で検討することである。【方法】システムを導入した2012年９月から2016年12月までの４年４か月間の当施設入所者1330名の内、褥瘡発生者220名を対象とし、スケールでのリスクの重症度と点数、再発率、および発生部位を後方視的に調査した。【結果】リスク重症度は中リスク群が一番多かった。再発率は再発者が49％であった。発生部位は臀部が一番多かった。【考察】中リスク群は個々によって身体能力に差があるが、褥瘡発生予防に対する意識や取り組みがされにくく、画一的な対応を行ったこと、体調変化により褥瘡発生のリスクが変動したことにより発生数が最も多くなったと考えられた。再発率は褥瘡が完治したことから、褥瘡再発生予防への意識が薄れ、褥瘡発生前の対応に戻った為、再発者が増えてしまったと考えられた。発生部位は殿部は範囲が広い為、座位時・臥床時共に圧がかかりやすく、特に座位時により圧がかかりやすいが、座位時間が長くなってしまうことによって発生頻度が高くなったと考えられた。
Efforts to reduce bedsore generation through a comprehensive bedsore care system at a nursing home health care facility:
― Consideration of occurrence rate of bedsores on OH scale (Ashina version) by degree of risk, recurrence rate, and occurrence site ―
Kobukai Masashi1)
Odagiri Toshihiro1)
Oku Toshiro2)
2) Department of Physical Therapy, Osaka University of Human Sciences
Abstract
Objective: To reduce the occurrence of bedsores in a nursing home health care facility, the characteristics of bedsore generation were examined, based on the OH scale （Ashina version） considering assessment of the bedsore risk and the recurrence rate and occurrence site.
Methods: We selected 220 patients suffering from bedsores among 1.330 subjects who entered the facility during the ４ years and 4 months from September 2012 through December 2016. The degree of severity and score on the scale, recurrence rate, and site of occurrence were retrospectively investigated.
Results: The risk severity was highest in the middle risk group. The recurrence rate was 49％ in relapse. The buttocks were the most frequent site of occurrence.
Discussion: Although there were differences in physical ability among the subjects in the middle risk group, it is thought that the reasons for the highest number of occurrences were that a unified treatment was given, although there were considerable differences in awareness and efforts toward prevention of bedsore occurrence, and that there was a change in the risk of bedsore occurrence due to changes in the subjects’ physical condition. Regarding the recurrence rate, it is thought that since, after bedsores were completely healed, awareness of prevention of recurrence was weakened, and treatment reverted to that before the occurrence of the bedsores, the number of relapses increased. In regard to site of occurrence, since the buttocks cover a relatively large area, pressure is liable to be applied both in the sitting position and when lying down, particularly in the sitting position. It is considered that the high frequency of occurrence was increased by the long time spent in the sitting position.