Abstract: Objective To investigate the effect of risk management in the prevention of pressure injury during the operation of the posterior spine approach. Methods 117 patients who underwent posterior spinal approachsurgery from April 2019 to March 2020 were selected. The management to prevent pressure injury during the operation was to adopt the newly created nursing model based on the evidence-based risk management in this operating room. A risk management team was established and focused on the risk points of pressure injury during posterior spinal surgery by formulating personnel homogenization training mechanisms, standard posture placement procedures, detailed management during placement. The effects of the new model of care were observed and recorded the occurrence of stress injuries. In addition, this study investigated the occurrence of pressure injuries in patients undergoing posterior spinal approach surgery from March 2018 to March 2019 who did not implement the new care model （conventional care group）, and compared the differences between the two types of patients. Results Injuries occurred in 6 of the 88 patients in conventional care group （9 locations, the incidence rate was 6.82%）, while none of the 117 patients in the new care model occurred. The difference between the two groups was statistically significant （χ²=8.2178, P=0.0041）. The new nursing model did not affect the operating room time and reduce nursing compliance, and the overall satisfaction of doctors was higher than that of the conventional model （χ²=7.44, P=0.0064）. Conclusion The implementation of an evidence-based nursing program can enable nurses to receive homogenized training, and various risk management measures can provide patients with delicate nursing services, thereby effectively reducing the incidence of intraoperative pressure injuries in patients undergoing spine surgery

Key words: posterior spinal surgery, pressure injury, operating room management

摘要： 目的 探讨风险管理在脊柱后入路手术中预防压力性损伤的效果。方法 选取2019年4月~2020年3月行脊柱后入路手术患者117例,手术过程中预防压力性损伤的管理方法是采用本手术室基于风险管理循证基础上新创建的护理模式,通过识别脊柱后路手术中发生压力性损伤的风险点,建立风险管理小组,制定人员同质化培训机制、标准体位摆置流程、摆置时的细节管理等措施。观察和记录这种护理模式的效果和压力性损伤的发生情况。选择2018年3月~2019年3月常规护理的脊柱后入路手术患者88例,分析两组压力性损伤的差异。结果 常规护理的88例患者中发生术中压力性损伤6例（9处,发生率为6.82%）,而新护理模式的117例患者中无一例发生,两组比较的差异有统计学意义（χ²=8.218,P=0.004）。新护理模式没有影响手术室的时间和降低护理依从性,医生的总满意度较常规模式提高（χ²=7.44,P=0.006）。结论 实施基于循证基础上的风险管理护理方案能使护士得到同质化培训,为患者提供更加精细的护理,进而有效降低脊柱后入路手术患者术中压力性损伤的发生。

关键词: 脊柱后入路手术, 压力性损伤, 手术室管理