NICU患儿医用粘胶相关性皮肤损伤最佳循证实践方案的应用

Implementation of evidence-based protocol to reduce medical adhesive-related skin injury in neonatal intensive care unit

目的探讨最佳循证实践方案在降低NICU患儿医用粘胶相关性皮肤损伤中的应用效果。方法将308例使用医用粘胶的患儿按时间分为对照组与观察组各154例。对照组实施常规护理,观察组构建“降低NICU患儿医用粘胶相关性皮肤损伤最佳循证实践方案”并实施。比较两组患儿医用粘胶相关性皮肤损伤发生率、移除粘胶产品后疼痛评分,循证实践前后医护人员的认知、行为改变。结果观察组患儿医用粘胶相关性皮肤损伤发生率及粘胶产品移除后疼痛评分显著低于对照组(均P<0.01)。方案实施后医生、护士对相关知识及行为评分显著高于实施前(P<0.05,P<0.01)。结论最佳循证实践方案的应用,可降低NICU患儿医用粘胶相关性皮肤损伤的发生率。

Objective To explore the effect of evidence-based protocol on reducing medical adhesive-related skin injury(MARSI)in neonatal intensive care unit(NICU).Methods A total of 308 newborns who used medical adhesives were chronologically divided into a control group and an observation group,with 154 in each group.The control group was given conventional nursing care,while the observation group received evidence-based nursing which was guided by a protocol regarding MARSI prevention in NICU.The incidence of MARSI and pain intensity after removal of the adhesives were compared between the two groups.Cognitive and behavioral changes of medical staff before and after the evidence-based practice were also evaluated.Results The observation group had lower incidence of MARSI and milder pain intensity compared with the control group(P<0.01 for both).After implementation of the evidence-based practice,MARSI knowledge and behaviors of pediatricians and nurses were significantly improved(P<0.05,P<0.01).Conclusion Implementation of evidence-based protocol can reduce the incidence of MARSI in NICU.