结构化皮肤护理方案对降低患者失禁性皮炎患病率的应用效果

The application of a structured skin care regimen to reduce incontinence-associated dermatitis

目的探讨和研究结构化皮肤护理方案应用于大便失禁患者预防失禁性皮炎(incontinence-associated dermatitis,IAD)的效果,为制订标准护理流程提供依据。方法选取ICU 80例大便失禁患者,根据随机数字表分为实验组(n=40)和对照组(n=40)。实验组应用结构化管理模式,制订并实施结构化的皮肤护理方案;对照组按大便失禁患者护理常规进行护理。护士经过相关培训后进行数据收集,确定患者是否存在IAD以及IAD的严重程度(Incontinence-Associated Dermatitis and its Severity Instrument,IADS),评价患者肛周及骶尾部的皮肤情况。结果实验组患者IADS得分明显低于对照组(P<0.01),压疮的发生率也低于对照组(P<0.01)。结论结构化及皮肤护理方案能减少患者皮肤暴露于粪便的频率,可降低压疮发展的可能性,减轻患者痛苦,同时降低临床护理负担。

Objective To measure the effects of a structured skin care regimen for patients with fecal inconti- nence and provide references for establishing nursing standards. Methods Totally 80 patients with fecal inconti- nence were recruited and assigned into the experimental group （n=40） and the control group （n=40） using random number table. A structured skin care regimen was developed and implemented in the experimental group,while the control group received routine nursing care. Nurses who received training in data collection were responsible for determining incontinence-associated dermatitis and its severity scores and assessing the perineal and sacral skin condition. Results Patients in the experimental group had significantly lower IADS scores （t=4.836,P〈0.001） than subjects in the control group and were less likely to develop pressure ulcer（x2=4.11,P〈0.05）. Conclusion The structured skin care regimen could decrease the frequency of skin exposed to fecal, decrease the possibility of the development of pressure ulcer, relieve the natients＇ pain. and decrease the clinical nurses＇ burden simultaneously.