Effect of graded nursing based on risk early warning concept on the incidence of pressure injury, quality of life, and negative affect of long-term bedridden patients.

Objective: To evaluate the effectiveness of graded nursing based on the risk early warning concept in long-term bedridden patients.

Methods: The medical records of 124 long-term bedridden patients admitted to the Department of Orthopaedics at the Yongzhou Hospital of Traditional Chinese Medicine from April 2022 to March 2024 were collected retrospectively. Patients were separated into two groups: the control group which received routine nursing, and the study group which received graded nursing based on the "risk early warning" concept. Key metrics recorded included turnover frequency and time to first out-of-bed activity, Braden score, incidence of pressure injury (PI), activities of daily living (ADL), motor function, quality of life, negative emotions, complications, and patient satisfaction.

Results: Low Barden score was a risk factor for PI in long-term bedridden patients (P<0.05, OR=0.040, 95% CI: 0.006-0.254). The turnover interval time and the time to first out-of-bed activity in the study group were shorter than those of the control group (all P<0.05). Compared to the control group, the Braden score, modified Barthel index score, Fugl-Meyer assessment score and quality of life scores of the study group were substantially higher (all P<0.05). The incidence of PI in the study group (4.62%) was lower than that of the control group (22.03%), and the area of PI in the study group was smaller than that of the control group (all P<0.05). Compared to the control group, the scores of self-rating anxiety scale and self-rating depression scale in the study group were substantially lower (all P<0.05). The study group had lower total incidence of complications (3.08% vs. 20.34%) and higher total satisfaction (95.38% vs. 79.66%) than the control group (all P<0.05).

Conclusion: Graded nursing based on the risk early warning concept is highly effective in managing long-term bedridden patients. It reduces the occurrence of PI and complications, shortens the turnover interval time and the time to first out-of-bed activity, improves activities of daily living and motor function as well as quality of life, relieves negative emotions, and improves patient satisfaction.