摘要
目的 探讨ICU失禁相关性皮炎(IAD)护理规范及其效果评价.方法 运用循证方法得出最佳证据,结合团队的临床经验及患者需求制订IAD护理规范,包括循证培训计划、风险预警流程、伤口分级护理流程和医护有效沟通模式.并将其应用于ICU质量改进项目中,评价IAD的总发生率及严重度发展情况.结果 改进前、中、后IAD的总发生率呈下降趋势,分别为22.43％ (96/428)、16.06 ％(71/442)、13.90 ％(51/367),差异有统计学意义(x2=11.06,P＜ 0.01).其中,重度IAD的发生率分别为2.57％ (11/428)、0.45％ (2/442)、0.27％ (1/367);伴发真菌感染的发生率分别为5.14％(22/428)、2.04％ (9/442)、1.63％ (6/367),差异有统计学意义(x2=11.67、10.53,P＜ 0.01).结论 应用循证实践规范了IAD护理,可改善护理质量,促进患者安全.
Objective To formulate standardized procedure of incontinence-associated dermatitis (IAD) in ICU and evaluate the outcomes.Methods The standardized procedure of IAD,including training program,risk assessment workflow,grading intervention process and physician-nurse communication style,was formulated based on the best evidences combined with the experience of clinical team and patients needs.Then,IAD standardized procedure was applied to the quality improvement project of ICU,and the incidence and severity degrees of IAD were evaluated.Results The total incidence of IAD was on the decline before,during and after improvement,22.43％(96/428),16.06％(71/442),13.90％(51/367),the difference was statistically significant (x2=11.06,P＜ 0.01).The incidence of severe IAD was 2.57％ (11/428),0.45％ (2/442),0.27％(1/367) before,during and after improvement,the difference was statistically significant (x2=11.67,P＜0.01).The incidence of fungal infection was 5.14％ (22/428),2.04％ (9/442),1.63％ (6/367) before,during and after improvement,the difference was statistically significant (x2=10.53,P ＜ 0.01).Conclusions Application of evidence-based practice with specification of IAD,can improve nursing quality and promote patient safety.
出处
《中国实用护理杂志》
2016年第1期-,共5页
Chinese Journal of Practical Nursing
基金
浙江省医药卫生科技计划(2015KYB256)Zhejiang Province Medical Science and Technology Project
关键词
皮炎
大便失禁
尿失禁
循证护理
Dermatitis
Fecal incontinence
Urinary incontinence
Evidence-based nursing
