降低加護病房失禁性皮膚炎發生率之專案

The Project to Reducing Incontinence-associated Dermatitis in an Intensive Care Unit

莊閔仁(Min-Jen Chuang) ； 禹美君(Mei-Chun Yu)

《長期照護雜誌》 20卷1期 (2016/05) Pp. 89-100

https://doi.org/10.6317/LTC.20.89

摘要

維持病人皮膚完整性為護理品質評值之重要指標，某教學醫院加護病房之失禁性皮膚炎平均發生率有逐年增加之情形，經現況分析後，發現原因為病人長時間處於尿液及糞便刺激的環境之中，該單位未制定相關照護標準作業流程及教育訓練；因此擬訂降低加護病房病人失禁性皮膚炎發生率之改善方案。方案介入後結果顯示：一、失禁性皮膚炎發生率由37.4%降至16.6%；二、護理師之失禁性皮膚炎照護措施完整率由78.7%提升為97.0%；三、病人暨家屬滿意度於2012 年高於平均值。期望透過此專案，建立單位對失禁性皮膚炎之標準照護流程及評值標準，提升護理師對失禁性皮膚炎病人之照護能力，進而提升護品質。

關鍵字

加護病房 ； 失禁性皮膚炎 ； 改善方案

並列摘要

Skin integrity is the key to care quality. The intensive care units (ICUs) find that the average annual incidence of incontinence-associated dermatitis (IAD) increases due to the long-term contacts with urine and feces, as well as the lack of care training and related standard. The results of the program we planned show that: (1) The IAD incidence rate has declined from 37.4% to 16.6%; (2) The care integrity has upgraded from 78.7% to 97.0%; (3) The satisfaction rate was above average in 2012. We hope to set operational and audit standards through this improvement program, and to improve the quality for IAD care by training the nurses.

並列關鍵字

intensive care unit (ICU) ； incontinence-associated dermatitis (IAD) ； improvement program

參考文獻

Baadjies, R., Karrouze, I., & Rajpaul, K. (2014). Using no-rinse skin wipes to treat incontinence-associated dermatitis. British Journal of Nursing, 23(20), 22-28. doi:10.12968/bjon.2014.23.Sup20.S22

Beekman, D., Schoonhoven, L., Verhaeghs, S., Heyneman, A., & Defloor, T. (2009). Prevention and treatment of incontinenceassociated dermatitis: Literature review. Journal of Advanced Nursing, 65(6), 1141-1154. doi:10.1111/j.1365-2648.2009.04986.x

Beeckman, D., Woodward, S., & Gray, M. (2011). Incontinence-associated dermatitis: Step-bystep prevention and treatment. British Journal of Community Nursing, 16(8), 382-389. doi:10.12968/bjcn.2011.16.8.382

Beeckman, D., Woodward, S., Rajpaul, K., & Vanderwee, K. (2011). Clinical challenges of preventing incontinence-associated dermatitis. British Journal of Nursing, 20(13), 784-790. doi:10.12968/bjon.2011.20.13.784

Gray, M. (2010). Optimal management of incontinence-associated dermatitis in the elderly. American Journal Clinical Dermatology, 11(3), 201-210. doi:10.2165/11311010-000000000-00000