基于关口前移的失禁相关性皮炎数字化防护体系的构建与应用

Construction and application of digital protection system for incontinence-associated dermatitis based on earlier prevention

目的构建基于关口前移的失禁相关性皮炎数字化防护体系,降低失禁相关性皮炎的发生率.方法依托护理信息化平台,浙江省人民医院护理团队运行基于关口前移的失禁相关性皮炎数字化防护体系模块.采用前后对比研究方法,随机选取2018年1-3月108例失禁及失禁相关性皮炎患者的数据作为运行前数据,2019年1-3月108例失禁及失禁相关性皮炎患者的数据作为运行后的数据.观察护理人员在两组患者失禁风险评估准确率、失禁相关性皮炎的部位及严重度评估(Incontinence Associated Dermatitis Severity Instrument,IADS)准确率、临床分期准确率、防护措施落实率方面的差异.同时,收集2018年1-3月和2019年1-3月全院住院患者的失禁相关性皮炎的发生率,比较两组的差异.结果与运行前相比,运行基于关口前移的失禁相关性皮炎数字化防护体系后,护理人员的失禁风险评估准确率(χ^2=38.095,P<0.01)、IADS评估准确率(χ^2=64.901,P<0.01)、临床分期准确率(χ^2=42.424, P<0.01)以及防护措施落实率(χ^2=50.000,P<0.01)均提升,差异均有统计学意义.住院患者失禁相关性皮炎的发生率由运行前的0.35%下降至运行后的0.06%,差异有统计学意义(χ^2=41.031,P<0.01).结论基于关口前移的失禁相关性皮炎数字化防护体系的运行能够降低失禁相关性皮炎的发生率,提高护理人员的防范及管理能力.

Objective To establish a digital protection system for incontinence-associated dermatitis based on earlier prevention to reduce the incidence of incontinence-associated dermatitis. Methods Based on the infbrmationization of nursing platform, we run the digital protection system module of incontinence-related dermatitis based on the forward moving of the prevention gateway in Zhejiang Provincial People s Hospital. Through comparative study, 108 patients with incontinence and incontinence-related dermatitis from January to March 2018 were randomly selected as the pre-operation data, and 108 patients with incontinence and incontinence-related dermatitis from January to March 2019 as the post-operation data. The nurses of the two groups were observed and compared in terms of their assessment accuracy in patients1 incontinence risk, position and Incontinence Associated Dermatitis Severity (IADS), clinical staging, and implementation of prevention strategies. Meanwhile, the incidence of incontinence-related dermatitis among all inpatients in the hospital from January to March in 2018 was compared with the same period of 2019. Results After the operation of the digital protection system for incontinence-related dermatitis based on earlier prevention, the nursing staffs accuracy rate in the risk assessment of incontinence (χ^2=38.O95, P < 0.01), IADS (χ^2=64.901, P < 0.01), clinical staging accuracy (χ^2=42.424, P<0.01) and the implementation of protective measures (χ^2=50.000, P<0.01) had significant statistical differences. The incidence of incontinence-related dermatitis in hospitalized patients decreased from 0.35% before operation to 0.06% after operation with statistical significance(χ^2=41.031, P < 0.01). Conclusions The operation of the digital protection system for incontinence-associated dermatitis based on earlier prevention can reduce the incidence of incontinence-associated dermatitis and improve the prevention and management competence of nursing staff.