无自理能力老年住院患者两种修甲方法的效果评价

Effect evaluation of two methods of manicure among aged hospitalized patients without self-care ability

目的探讨无自理能力老年患者的剪甲方法，以提高基础护理质量，防止足部感染。方法选取2016年6—8月在上海市松江区新桥镇社区卫生服务中心老年病房和松江社会福利院医疗区住院的老年患者41例为研究对象。以老年患者左手和左足为研究组，右手和右足为对照组。对照组用37～40℃温水浸泡30min后修剪，研究组用油棉球湿敷完全包裹住需修剪甲，套上橡胶指套30min后修剪。测定两组剪甲修剪合格率、患者疼痛评分、辅助护士的人力支出时间、修剪时间、飞溅情况、指（趾）损伤等情况。结果两组轻、重度增厚甲的修剪合格率、剪甲过程中发生疼痛的肢体数、准备过程中辅助护士的人力支出时间、护士修剪耗时、甲飞溅情况、轻度重度增厚甲指（趾）损伤情况比较，差异均有统计学意义（P〈0．05）。结论油棉球湿敷法可以提高剪甲合格率和速度，使老年患者感到舒适，提高了护理质量，同时降低了足部感染风险，减少了人力成本。

Objective To explore the effective method of manicure for aged patients without self-care ability, in order to improve the quality of basic nursing and prevent foot infection. Methods Totally 41 aged patients staying in Songjiang Social Welfare Institute and Community Health Service Center of Xinqiao Town from June to August 2016 were selected as research objects. The left hands and left feet of aged patients were taken as the observation group, while the right hands and right feet of aged patients were taken as the control group. In the observation group, nails were trimmed after wrapped by rubber gloves with oil cotton ball for 30 min. In the control group, patients＇ hands and feet were soaked in warm water for 30 min before manicure. The pass rate of manicure, patients＇ pain score, preparation time of assistant nurses, trimming time, nails＇ splash and damage situation were detected in two groups. Results There were significant differences in the comparison of the pass rate of manicure in mild thickening nails group and severe thickening nails group, the number of limbs feeling pain in the process of manicure, patients＇ pain score, preparation time of assistant nurses, time spent on manicure, nails＇ splash and damage situation between two groups （P 〈 0.05）. Conclusions Wet compress with oil cotton ball can improve the pass rate and efficiency of manicure, increase patients＇ comfort, improve nursing quality and reduce the risk of foot infection and human cost.