中文摘要：

目的探索使用＂1＋3＂质量管理模式用于防范患者压疮发生的临床价值。方法在预防压疮时,我们使用＂1＋3＂质量管理模式：即出现问题时要寻找本源且针对性地完善、制定一套有效流程,并进行分享,以防相似问题再次发生。成立住院患者压疮防范管理小组,将重症监护室、放疗科等5个压疮高风险科室作为重点科室进行试点观察。结果自防压疮方案在全院各科室实施后,统计2011年1~6月期间,高危人群压疮发生率降至1.6%,压疮预防管理措施落实缺陷率降至2.7%,压疮诊疗规范缺陷率降至3.8%,环节缺陷率降至21%（P〈0.05）。结论针对病人压疮事件,应及时采用＂1＋3＂质量管理模式对其产生原因进行分析、优化防范方案并适当整改,积极主动地为患者创造安全的医疗环境,减少压疮的发生。

英文摘要：

Objective In order to explore the effect of using ＂1＋3＂ quality management model for prevention of pressure sores in hospitalized patients. Methods In prevention of pressure ulcer, we use ＂1＋3＂ quality management mode：finding a bedsore patient, establishing a set of effective processes, and then, sharing with other stuff for avoiding recurrence. Hospital bedsore prevention management group was established. Five high risk departments, such as ICU,radiotherapy and est., were set up as key departments for experimental observation. Results After self pressure sore prevention program implemented in the whole hospital from January of 2011 to June of 2011, bedsore rate in high risk patients, bedsore prevention management implantation defects rate, bedsore standard treatment defects rate, and link defects rate were decreased to 1.6%, 2.7% and 21%, separately. Conclusion Therefore, we should promptly find its reason and propose prevention scheme and optimize it by using the ＂1 ＋3＂ quality management mode when we met a new bedsore case in hospital. From that, we can actively create safe medical environment and reduce the incidence of pressure ulcers for patients in hospital.