失效模式与效应分析的预警性皮肤管理在老年危重患者中的作用探讨

Role of early warning skin management based on FMEA in elderly critical patients

目的探讨基于失效模式与效应分析(FMEA)的预警性皮肤管理在老年危重患者中的作用。方法选取空军军医大学第一附属医院2019年4月~2020年10月收治的106例老年危重患者,采用随机数表法分两组,分别予以常规皮肤管理(对照组)和基于FMEA的预警性皮肤管理(观察组)。对比两组管理前后对失禁性皮炎、压疮防控认知情况,皮肤管理期间配合度,失禁性皮炎和压疮发生率及持续时间。结果管理后两组对失禁性皮炎、压疮防控认知评分均较管理前升高,且观察组认知评分均高于对照组,差异有统计学意义(P<0.05);皮肤管理期间观察组配合度分布与对照组差异有统计学意义(P<0.05),观察组优良率高于对照组,差异有统计学意义(P<0.05);观察组失禁性皮炎、压疮发生率均低于对照组,且持续时间均短于对照组,差异有统计学意义(P<0.05)。结论在老年危重患者中应用基于FMEA的预警性皮肤管理能够改善其对失禁性皮炎、压疮防控的认知情况,提高配合度,降低失禁性皮炎和压疮发生率,还可缩短持续时间。

Objective To explore the role of early warning skin management based on failure mode and effect analysis(FMEA)in elderly critical patients.Methods 106 elderly critically ill patients were randomly divided into two groups,routine skin management(control group)and early warning skin management based on FMEA(Study Group).The cognition situations of incontinence dermatitis and pressure ulcer prevention and control before and after management,the degrees of cooperation during skin management,the incidences and duration of incontinence dermatitis and pressure ulcer were compared between the two groups.Results After management,the cognitive scores of incontinence dermatitis and pressure sore prevention and control in the two groups were higher than those before management(P<0.05),and the cognitive scores in the study group were higher than those in the control group(P<0.05).There was a significant difference in the degrees of cooperation during skin management between the study group and the control group(P<0.05).The excellent and good rate of the study group was higher than that of the control group(P<0.05).The incidences of incontinence dermatitis and pressure ulcer in the study group were lower than those in the control group(P<0.05),and the duration of incontinence dermatitis and pressure ulcer in the study group were shorter than those in the control group(P<0.05).Conclusion The application of FMEA based early warning skin management in elderly critical patients can improve their cognition of incontinence dermatitis and pressure ulcer prevention and control,improve the degree of cooperation,reduce the incidence of incontinence dermatitis and pressure ulcer,and shorten the duration.