预防危重患者失禁相关性皮炎护理流程的构建与应用

Construction and application of nursing process preventing critical patients fromincontinence-associated dermatitis

目的 构建预防危重症患者失禁相关性皮炎（IAD）的护理流程,为临床护士预防IAD的发生提供理论依据.方法 以护理程序为基础,通过循证方法 ,采用系统评价和专家咨询方法 形成预防IAD护理流程的初步框架和条目池,对江苏省南通市22名护理专家进行调研,通过2轮专家咨询,确定流程最终内容.将构建的流程应用于2014年7月—12月88例住院危重症患者IAD的预防.结果 形成《预防危重症患者IAD的护理流程》,包括IAD的风险评估、预防IAD的护理措施及IAD严重程度的评估3个方面.88例患者中4例发生了IAD,IAD的发生率4.5%,低于实施流程前的25.7%.结论 预防ICU患者失禁相关性皮炎护理流程的构建为临床护理人员提供了较为规范的理论依据,具有科学性、可行性和实用性.

Objective To construct nursing process for critically ill patients preventing incontinence-associated dermatitis（IAD）, and provide theoretical basis for clinical nurses to prevent arising of IAD. Methods In basis of nursing procedure, preliminaryframework and entry pool of IAD-preventing nursing process were formed through evidence-based systematic evaluation and expert consulting, and a final content of the process was determined by a survey of 22 nursing specialists in Nantong with 2 rounds of expert consulting. The formatted process was applied in 88 hospitalized critically ill patients to prevent IAD from July to December in 2014. Results ＆quot;Nursing Process of IAD prevention for Critically ill patients＇ was formatted, including 3 aspects：risk assessment of IAD, nursing management for IAD prevention and IAD severity assessing. IAD occurred to 4 out of 88 patients, of which the occurrence rate was 4. 5%, which was lower than 25. 7% of that before performing of the process. Conclusions The construction of nursing process preventing intensive care unit patients from Incontinence-associated dermatitis provides a relatively standardized theoretical basis for clinical nursing workers scientifically, feasibly and practicably.