ICU失禁相关性皮炎预防和治疗策略在临床中的应用
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摘要
目的:通过制定ICU失禁相关性皮炎(incontinence-associated dermatitis,IAD)预防和治疗策略,指导医务人员加强对危重患者IAD的预防控制,以提升医疗护理质量。方法:通过检索文献,访谈ICU医护人员及查阅IAD病例资料等方法,分析并归纳IAD预防控制安全管理中的常见问题。依据《国内外失禁相关性皮炎护理实践专家共识解读》及临床实践需求制定ICU失禁相关性皮炎预防和治疗策略。2017年8月至2018年7月,通过开展ICU医疗专业人员教育,建立IAD预防和治疗流程,进行质量控制等推行失禁相关性皮炎预防和治疗策略。对比应用预防和治疗策略前后l AD的发生率及严重度发展情况。结果:实施预防和治疗策略后,IAD的发生率低于实施前,差异有统计学意义(P <0.01)。IAD1级、2级的病例数低于实施前,差异有统计学意义(P <0.05)。结论:ICU失禁相关性皮炎预防和治疗策略对危重患者IAD的预防控制有较好的临床指导作用。
Objective:To guide medical staff strengthen the prevention and control of IAD in critically ill patients by formulating prevention and treatment strategies for incontinence-associated dermatitis(IAD) in ICU, so as to improve the quality of medical care.Method:We analyze and summarize the common problems in IAD prevention and control safety management by searching literature, interviewing ICU medical staff and consulting IAD case data,etc.The prevention and treatment strategies of incontinence-associated dermatitis in ICU were formulated according to the Interpretation of domestic and foreign expert consensuses of Incontinence-Associated Dermatitis nursing and the needs of clinical practice.From August 2017 to July 2018, The prevention and treatment strategies for incontinenceassociated dermatitis was implemented by education of ICU medical professionals, establishment of IAD prevention and treatment processes and implementation of quality control.Comparing the incidence and severity of lAD before and after the application of prevention and treatment strategies Result:After the implementation of prevention and treatment strategies, the incidence of IAD was lower than that before implementation, and the difference was statistically significant(P < 0.01).The number of IAD1 and IAD2 cases was lower than that before implementation,and the difference was statistically significant(P <0.05).Conclusion:The prevention and treatment strategies of ICU incontinence-associated dermatitis have a good clinical guidance for the prevention and control of IAD in critically ill patients.
Objective:To guide medical staff strengthen the prevention and control of IAD in critically ill patients by formulating prevention and treatment strategies for incontinence-associated dermatitis(IAD) in ICU, so as to improve the quality of medical care.Method:We analyze and summarize the common problems in IAD prevention and control safety management by searching literature, interviewing ICU medical staff and consulting IAD case data,etc.The prevention and treatment strategies of incontinence-associated dermatitis in ICU were formulated according to the Interpretation of domestic and foreign expert consensuses of Incontinence-Associated Dermatitis nursing and the needs of clinical practice.From August 2017 to July 2018, The prevention and treatment strategies for incontinenceassociated dermatitis was implemented by education of ICU medical professionals, establishment of IAD prevention and treatment processes and implementation of quality control.Comparing the incidence and severity of lAD before and after the application of prevention and treatment strategies Result:After the implementation of prevention and treatment strategies, the incidence of IAD was lower than that before implementation, and the difference was statistically significant(P < 0.01).The number of IAD1 and IAD2 cases was lower than that before implementation,and the difference was statistically significant(P <0.05).Conclusion:The prevention and treatment strategies of ICU incontinence-associated dermatitis have a good clinical guidance for the prevention and control of IAD in critically ill patients.
引文
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[2]Gray M,BeeckmanD,Bliss D Z,etal.Incontinence-associated dermatitis:a comprehensive review and update[J].J Wound ostomycontinence nurs,2012,39(1):61-74.
[3]Bliss DZ,savik K,thorson MA,et a1.Incontinenceassociated dermatitis in critically ill adults:time to development,severity,and risk factors[J].J Wound ostomy continence nurs,2011,38(4):433-445.
[4]王泠,郑小伟,马蕊,等.国内外失禁相关性皮炎护理实践专家共识解读[J].中国护理管理,2018,18(1):3-6.
[5]Beeckman D.Proceedings of the Global IAD expert panel.Incontinence-associated dermatitis:moving prevention forward[Z].2015e21.
[6]nix D H.Validity and reliability of the Perineal Assessment tool[J].ostomy Wound Manage,2002,48(2):43-46,48-49.
[7]Beeckman D.Proceedings of the Global IAD expert panel.Incontinence-associated dermatitis:moving prevention forward[Z].2015e21.
[8]Beeckman,Dimitri,VanDamme,et al.Incontinenceassociated dermatitis(IAD):an update[J].Dermatological nursing,2015,14(4):32-36.
[9]Langemo D,Hanson D,Hunter s,et al.Incontinence and incontinence-associated dermatitis[J].Advances in skin&wound care,2011,24(3):141-142.
[10]Demarre L,Verhaeghe s,Van Hecke A,et al.Factors predicting the development of pressure ulcers in an atrisk population whoreceive standardized preventive care:secondary analyses of a multicentrerandomised controlled trial[J].J Adv nurs,2015,71(2):391-403.
[11]Beeckman D,Van Lancker A,Van Hecke A,et al.Asystematic Review and Meta-Analysis of IncontinenceAssociatedDermatitis,Incontinence,and Moisture as Risk Factors for Pressure Ulcer Development[J].2014,37(3):204-218.
[12]national Pressure Ulcer Advisory Panel,european Pressure Ulcer Advisor y Panel and Pan Pacifi Pressure Injury Alliance.Preventionand treatment of Pressure Ulcers:Quick Reference Guide[M].osborne Park,Western Australia:emilyHaesler(ed.).cambridgeMedia,2014.
[13]Junkin J,selekof J L.Beyond"diaper rash":Incontinence-associated dermatitis:does it have you seeing red?[J].nursing,2008,38(11 suppl):51h-56h,10h-56h.
[14]Park K H.the effect of a silicone border foam dressing for prevention of pressure ulcers and incontinenceassociated dermatitis inintensive care unit patients[J].JWound ostomy continence nurs,2014,41(5):424-429.
[2]Gray M,BeeckmanD,Bliss D Z,etal.Incontinence-associated dermatitis:a comprehensive review and update[J].J Wound ostomycontinence nurs,2012,39(1):61-74.
[3]Bliss DZ,savik K,thorson MA,et a1.Incontinenceassociated dermatitis in critically ill adults:time to development,severity,and risk factors[J].J Wound ostomy continence nurs,2011,38(4):433-445.
[4]王泠,郑小伟,马蕊,等.国内外失禁相关性皮炎护理实践专家共识解读[J].中国护理管理,2018,18(1):3-6.
[5]Beeckman D.Proceedings of the Global IAD expert panel.Incontinence-associated dermatitis:moving prevention forward[Z].2015e21.
[6]nix D H.Validity and reliability of the Perineal Assessment tool[J].ostomy Wound Manage,2002,48(2):43-46,48-49.
[7]Beeckman D.Proceedings of the Global IAD expert panel.Incontinence-associated dermatitis:moving prevention forward[Z].2015e21.
[8]Beeckman,Dimitri,VanDamme,et al.Incontinenceassociated dermatitis(IAD):an update[J].Dermatological nursing,2015,14(4):32-36.
[9]Langemo D,Hanson D,Hunter s,et al.Incontinence and incontinence-associated dermatitis[J].Advances in skin&wound care,2011,24(3):141-142.
[10]Demarre L,Verhaeghe s,Van Hecke A,et al.Factors predicting the development of pressure ulcers in an atrisk population whoreceive standardized preventive care:secondary analyses of a multicentrerandomised controlled trial[J].J Adv nurs,2015,71(2):391-403.
[11]Beeckman D,Van Lancker A,Van Hecke A,et al.Asystematic Review and Meta-Analysis of IncontinenceAssociatedDermatitis,Incontinence,and Moisture as Risk Factors for Pressure Ulcer Development[J].2014,37(3):204-218.
[12]national Pressure Ulcer Advisory Panel,european Pressure Ulcer Advisor y Panel and Pan Pacifi Pressure Injury Alliance.Preventionand treatment of Pressure Ulcers:Quick Reference Guide[M].osborne Park,Western Australia:emilyHaesler(ed.).cambridgeMedia,2014.
[13]Junkin J,selekof J L.Beyond"diaper rash":Incontinence-associated dermatitis:does it have you seeing red?[J].nursing,2008,38(11 suppl):51h-56h,10h-56h.
[14]Park K H.the effect of a silicone border foam dressing for prevention of pressure ulcers and incontinenceassociated dermatitis inintensive care unit patients[J].JWound ostomy continence nurs,2014,41(5):424-429.