4R危机管理理论在ICU患者皮肤保护中的应用效果

Application of 4R-model crisis management theory in skin care of patients in ICU

目的：探讨4R 危机管理理论在 ICU 患者皮肤保护中的应用效果。方法以2013年1—12月哈尔滨医科大学第一附属医院 ICU 收治的800例患者为对照组，以常规皮肤护理方法护理；以2014年1—12月我院 ICU 收治的850例患者为观察组，对患者采用4R 危机管理理论进行皮肤护理管理。护理期间记录并比较两组压疮、皮肤破损、湿疹、冻（烫）伤发生率和院外压疮好转情况。结果观察组皮肤问题发生率明显低于对照组，两组比较差异有统计学意义（P ＜0．05）；观察组护理工作质量评分均优于对照组，两组比较差异有统计学意义（P ＜0．05）。结论4R 危机管理理论可有效预防 ICU 患者皮肤相关并发症的发生，为 ICU 患者皮肤管理提供科学、连续、有效的管理方法。

Objective To explore the application of 4R-model crisis management theory in skin care of patients in ICU.Methods A total of 800 patients in ICU of our hospital between January and December 201 3 were included as control group received routine skin care.A total of 850 patients in ICU of our hospital between January and December 201 4 were included in observation group and given skin care based on 4R-model crisis management theory. The incidence of pressure ulcers, skin damage, eczema, scald, frostbite and the improvement of pressure ulcers were record and compared in two groups.Results The incidence of skin problems in the observation group was significantly lower than that in the control group.The difference between two groups was statistically significant （P 〈0.05）.The score of nursing quality in the observation group was higher than that in the control group.The difference between two groups was statistically significant （P 〈0.05）.Conclusions The application of 4R-model crisis management theory can effectively prevent the occurrence of skin complications of patients in ICU,and provide a scientific,continuous and effective management for skin care of patients in ICU.