拋棄式擦澡巾提升重症病人床上擦澡成效之實證臨床應用

Using Disposable Bathing Wipes to Improve Bathing for Critically Ill Patients

楊麗瓊(Li-Chiung Yang) ； 王麒嘉(Qi-Jia Wang) ； 林俐君(Le-Gin Lin) ； 劉雅云(Ya-Yun Liu) ； 廖淑貞(Shu-Chen Liao) ； 鄒怡真(Yi-Chen Tsou)

《榮總護理》 35卷2期 (2018/06) Pp. 145-151

https://doi.org/10.6142/VGHN.201806_35(2).0004

摘要

床上擦澡能夠協助重症病人維持身體清潔、舒適度及減少病源傳播。然傳統擦澡方式有重複使用毛巾、不適當儲放及無法晾乾等問題，本文探討以拋棄式擦澡巾執行重症病人床上擦澡之成效。文中以實證手法搜尋文獻，透過關鍵字於PubMed及MEDLINE資料庫搜尋系統性文獻回顧及隨機對照試驗文章，使用拋棄式擦澡工具取代傳統式擦澡毛巾，臨床運用期為2014年1月30日至2015年7月30日，對象為重症加護室的病人及護理師，以滿意度、護理工時、經濟效益及感染發生密度為成效指標。結果發現拋棄式擦澡巾的介入後，護病雙方均有高滿意度、擦澡時間平均節省22分鐘、護理人力成本平均節省92元/位、經濟效益方面比傳統床上擦澡節省10,773元、平均感染密度從千分之14.5降至千分之11.3。拋棄式擦澡巾能夠降低感染源、增加病人舒適感，讓護理師及病人有較高之滿意度，更能在成本效益中節省人力及物料成本。

關鍵字

拋棄式擦澡巾 ； 重症病人 ； 感染率 ； 成本效益 ； 滿意度

並列摘要

Providing bed baths can help critically ill patients stay clean and comfortable. However, using the same basin for bathing may cause cross-contamination between different parts of the body. Preparing traditional bed baths also has notable labor costs. In addition, inappropriate storing of reusable washbasins and wet towels can lead to microbial biofilm formation, which increases the risk of infection for patients. Thus, questions of hygiene, comfort, and cross-contamination during bed bathing have become a concern in nursing practice. In this study, evidence-based practice was used to investigate the effect of using disposable bathing towels when bathing critical patients in order to evaluate the cost-effectiveness of such towels versus traditional bed bathing methods. Possible problems and solutions were identified be searching the PubMed and MEDLINE databases to identify related articles. According to studies, using disposable bath towels instead of traditional bed baths was more economical and contributed to higher satisfaction among nurses and patients as well as lower infection rates. Data collection was conducted from January 1, 2014 to July 30, 2015. The participants were critical patients in an intensive care unit and the nurses responsible for their care. The outcome was based on the number of multidrug resistant strains found towels as well as the cost effectiveness, required labor, and satisfaction levels. The findings revealed higher satisfaction levels among nurses and patients when using disposable bath towels, increasing from 31% to 100% in the nurses and up to 90% in the patients. These disposable bath towels reduced bathing times to an average of 13 minutes from an average of 35 minutes using traditional bed bathing methods. Moreover, the new disposable bath towel method provided savings of up to NT$90 per person for every bath. This would provide savings of NT$10,773.60 per person per year. In addition, the annual average infection rate was 11.3%, which was lower than the threshold (14.5%). In summary, using disposable bath towels for bed bathing significantly reduces infection and increases comfort and satisfaction while saving nursing labor and material costs.

並列關鍵字

disposable bathing wipes ； critically ill patients ； infection rate ； cost-effective ； satisfaction

參考文獻

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