老年失禁性皮炎患者的过程管控集束化护理
|
摘要
目的探讨基于过程管控的集束化管理策略对老年患者失禁性皮炎发生率的影响。方法采取历史对照设计,将709例心血管专科老年失禁患者分为对照组365例和观察组344例。对照组采取常规护理措施,观察组按过程管控的步骤实施失禁性皮炎预防集束化管理策略,包括确定管控关键元素、确定管控标准、过程监测、过程改进。结果观察组失禁性皮炎发生率显著低于对照组(P<0.01)。结论基于过程管控的集束化管理策略可有效降低住院老年失禁患者失禁性皮炎发生率。
Objective To explore the effect of bundle care based on process management on the incidence of incontinence associated dermatitis in elderly patients.Methods A historical controlled study was conducted, with previous 365 incontinence patients being seen as the control group, who received routine nursing care. Another 344 incontinence patients(the intervention group) were prospectively assigned to received bundle care based on process management: nurses determined the key elements of incontinence control, established standards for incontinence control, and performed process monitoring, and process improvement.Results The incidence rate of incontinence associated dermatitis in the intervention group was significantly lower than that in the control group(P<0.01).Conclusion Bundle care based on process management can effectively reduce the incidence rate of incontinence associa-ted dermatitis in hospitalized elderly incontinence patients.
Objective To explore the effect of bundle care based on process management on the incidence of incontinence associated dermatitis in elderly patients.Methods A historical controlled study was conducted, with previous 365 incontinence patients being seen as the control group, who received routine nursing care. Another 344 incontinence patients(the intervention group) were prospectively assigned to received bundle care based on process management: nurses determined the key elements of incontinence control, established standards for incontinence control, and performed process monitoring, and process improvement.Results The incidence rate of incontinence associated dermatitis in the intervention group was significantly lower than that in the control group(P<0.01).Conclusion Bundle care based on process management can effectively reduce the incidence rate of incontinence associa-ted dermatitis in hospitalized elderly incontinence patients.
引文
[1] 张大伟.浅谈过程控制在企业生产经营管理中的重要性[J].中国科技纵横,2012(6):212.
[2] 吴密彬,胡雁.集束化护理的误区分析与正确应用[J].护理学杂志,2013,28(18):84-86.
[3] Gray M,Bliss D Z,Doughty D B,et al.Incontinence-associated dermatitis:a consensus[J].J Wound Ostomy Continence Nurs,2007,34(1):45-54.
[4] Beeckman D.A decade of research on Incontinence-Associated Dermatitis (IAD):evidence,knowledge gaps and next steps[J].J Tissue Viability,2017,26(1):47-56.
[5] Long M A,Reed L A,Dunning K,et al.Incontinence-associated dermatitis in a long-term acute care facility[J].J Wound Ostomy Continence Nurs,2012,39(3):318-327.
[6] Campbell J L,Coyer F M,Osborne S R.Incontinence-associated dermatitis:a cross-sectional prevalence study in the Australian acute care hospital setting[J].Int Wound J,2016,13(3):403-411.
[7] Junkin J,Selekof J L.Beyond "diaper rash":Incontinence-associated dermatitis:does it have you seeing red[J].Nursing,2008,38(11 Suppl):1-10.
[8] Beeckman D,Campbell J,Campbell K,et al.Incontinence-associated dermatitis:moving prevention forward[C/OL]//The Global IAD Expert Panel.Proceedings of the Global IAD Expert Panel.(2014-09)[2018-10-29].https://www.researchgate.net/publication/276468311_Proceedings_of_the_Global_IAD_Expert_Panel_Incontinence-associated_dermatitis_moving_prevention_forward.
[9] Beeckman D,Van Lancker A,Van Hecke A,et al.A systematic review and meta-analysis of incontinence-associated dermatitis,incontinence,and moisture as risk factors for pressure ulcer development[J].Res Nurs Health,2014,37(3):204-218.
[10] Vincent C.Topical skin care for older people[J].The JBI Evidence Summary,2014,24(3):1-3.
[11] Kottner J,Lichterfeld A,Blume-Peytavi U.Maintaining skin integrity in the aged:a systematic review[J].Br J Dermatol,2013,169(3):528-542.
[12] 谢春晓,张静,吴娟.皮肤保护预防失禁相关性皮炎的系统评价[J].护理学杂志,2013,28(3):81-84.
[13] Beeckman D,Verhaeghe S,Defloor T,et al.A 3-in-1 perineal care washcloth impregnated with dimethicone 3% versus water and pH neutral soap to prevent and treat incontinence-associated dermatitis:a randomized,controlled clinical trial[J].J Wound Ostomy Continence Nurs,2011,38(6):627-634.
[14] 钱丹,曹燕,蔡亚萍,等.集束化护理在预防ICU病人失禁性相关性皮炎中的应用[J].护理研究,2015,29(10):3818-3819.
[15] 杨燕,汪苗,徐九云,等.失禁相关性皮炎护理风险预案制订及应用效果评价[J].护理学杂志,2016,31(12):55-57.
[16] 康宙清,杨颖,季蕊,等.失禁相关性皮炎标准化预防及护理指引在老年失禁患者中的应用[J].安徽医药,2018,22(6):1199-1202.
[17] 徐晶晶,贾静,仇晓溪.失禁病人发生失禁性皮炎的危险因素分析[J].护理研究,2016,30(2):597-599.
[18] National Pressure Ulcer Advisory Panel (NPUAP),European Pressure Ulcer Advisory Panel (EPUAP) and Pan Pacific Pressure Injury Alliance (PPPIA).Prevention and treatment of pressure ulcers:quick re-ference guide[EB/OL].(2014)[2018-10-23].https://www.npuap.org/wp-content/uploads/2014/08/Updated-10-16-14-Quick-Reference-Guide-DIGITAL-NPUAP-EPUAP-PPPIA-16Oct2014.pdf.
[19] Minassian V A,Devore E,Hagan K,et al.Severity of urinary incontinence and effect on quality of life in women by incontinence type[J].Obstet Gynecol,2013,121(5):1083-1090.
[20] Bartlett L,Nowak M,Ho Y H.Impact of fecal incontinence on quality of life[J].World J Gastroenterol,2009,15(26):3276-3282.
[21] Centers for Disease Control (CDC).Urinary incontinence among hospitalized persons aged 65 years and older—United States,1984-1987[J].MMWR Morb Mortal Wkly Rep,1991,40(26):433-436.
[2] 吴密彬,胡雁.集束化护理的误区分析与正确应用[J].护理学杂志,2013,28(18):84-86.
[3] Gray M,Bliss D Z,Doughty D B,et al.Incontinence-associated dermatitis:a consensus[J].J Wound Ostomy Continence Nurs,2007,34(1):45-54.
[4] Beeckman D.A decade of research on Incontinence-Associated Dermatitis (IAD):evidence,knowledge gaps and next steps[J].J Tissue Viability,2017,26(1):47-56.
[5] Long M A,Reed L A,Dunning K,et al.Incontinence-associated dermatitis in a long-term acute care facility[J].J Wound Ostomy Continence Nurs,2012,39(3):318-327.
[6] Campbell J L,Coyer F M,Osborne S R.Incontinence-associated dermatitis:a cross-sectional prevalence study in the Australian acute care hospital setting[J].Int Wound J,2016,13(3):403-411.
[7] Junkin J,Selekof J L.Beyond "diaper rash":Incontinence-associated dermatitis:does it have you seeing red[J].Nursing,2008,38(11 Suppl):1-10.
[8] Beeckman D,Campbell J,Campbell K,et al.Incontinence-associated dermatitis:moving prevention forward[C/OL]//The Global IAD Expert Panel.Proceedings of the Global IAD Expert Panel.(2014-09)[2018-10-29].https://www.researchgate.net/publication/276468311_Proceedings_of_the_Global_IAD_Expert_Panel_Incontinence-associated_dermatitis_moving_prevention_forward.
[9] Beeckman D,Van Lancker A,Van Hecke A,et al.A systematic review and meta-analysis of incontinence-associated dermatitis,incontinence,and moisture as risk factors for pressure ulcer development[J].Res Nurs Health,2014,37(3):204-218.
[10] Vincent C.Topical skin care for older people[J].The JBI Evidence Summary,2014,24(3):1-3.
[11] Kottner J,Lichterfeld A,Blume-Peytavi U.Maintaining skin integrity in the aged:a systematic review[J].Br J Dermatol,2013,169(3):528-542.
[12] 谢春晓,张静,吴娟.皮肤保护预防失禁相关性皮炎的系统评价[J].护理学杂志,2013,28(3):81-84.
[13] Beeckman D,Verhaeghe S,Defloor T,et al.A 3-in-1 perineal care washcloth impregnated with dimethicone 3% versus water and pH neutral soap to prevent and treat incontinence-associated dermatitis:a randomized,controlled clinical trial[J].J Wound Ostomy Continence Nurs,2011,38(6):627-634.
[14] 钱丹,曹燕,蔡亚萍,等.集束化护理在预防ICU病人失禁性相关性皮炎中的应用[J].护理研究,2015,29(10):3818-3819.
[15] 杨燕,汪苗,徐九云,等.失禁相关性皮炎护理风险预案制订及应用效果评价[J].护理学杂志,2016,31(12):55-57.
[16] 康宙清,杨颖,季蕊,等.失禁相关性皮炎标准化预防及护理指引在老年失禁患者中的应用[J].安徽医药,2018,22(6):1199-1202.
[17] 徐晶晶,贾静,仇晓溪.失禁病人发生失禁性皮炎的危险因素分析[J].护理研究,2016,30(2):597-599.
[18] National Pressure Ulcer Advisory Panel (NPUAP),European Pressure Ulcer Advisory Panel (EPUAP) and Pan Pacific Pressure Injury Alliance (PPPIA).Prevention and treatment of pressure ulcers:quick re-ference guide[EB/OL].(2014)[2018-10-23].https://www.npuap.org/wp-content/uploads/2014/08/Updated-10-16-14-Quick-Reference-Guide-DIGITAL-NPUAP-EPUAP-PPPIA-16Oct2014.pdf.
[19] Minassian V A,Devore E,Hagan K,et al.Severity of urinary incontinence and effect on quality of life in women by incontinence type[J].Obstet Gynecol,2013,121(5):1083-1090.
[20] Bartlett L,Nowak M,Ho Y H.Impact of fecal incontinence on quality of life[J].World J Gastroenterol,2009,15(26):3276-3282.
[21] Centers for Disease Control (CDC).Urinary incontinence among hospitalized persons aged 65 years and older—United States,1984-1987[J].MMWR Morb Mortal Wkly Rep,1991,40(26):433-436.