- 期刊
運用擴散理論降低外科加護病房失禁性皮膚炎發生率
Using Diffusion of Innovations Theory to Reduce the Incidence of Incontinence-associated Dermatitis in Surgical Intensive Care Unit
摘要
加護病房病人因活動侷限於床及抗生素、軟便劑使用，加上管灌飲食，導致治療性腹瀉，若未提供正確照護，造成失禁性皮膚炎發生率高，因而引發專案改善動機。本專案目的為降低外科加護病房失禁性皮膚炎發生率，經由現況分析，發現造成失禁性皮膚炎發生率高原因為1.人員照護認知及行為不正確、2.保濕防護廠牌眾多、3.缺乏臀部通風設備、4.缺乏分級照護流程、5.病人使用管灌飲食及抗生素。創新擴散理論導入改善策略：1.舉辦失禁性皮膚炎臨床照護工作坊及製作分級辨識圖卡、2.整合保濕防護產品、3.創新製作通透罩、4.修訂分級照護流程、5.團隊溝通腹瀉照護流程等實施後，發生率由15.4%降至3.1%，達專案目的。顯示創新擴散理論的運用，能創新評估工具及整合皮膚照護分級規範，由單一單位人員採用及成效佳，再向外擴散至其他急重症單位，提升急重症皮膚照護品質。
並列摘要
The critically ill patients that used multiple antibiotics, drug of laxatives, and nasogastric feeding almost have therapeutic associated diarrhea. If the patients were badly cared, they increased rate of incidence of incontinence-associated dermatitis. The purpose of this project was reduce the incidence of incontinence-associated dermatitis in the surgical intensive care unit. According the data collection and analysis, the reasons included incorrect cognition and behavior of skin care, many kinds of skin protectant, lack of buttock ventilation implementation, lack of graded care protocol, and the patients’ use of antibiotics and nasogastric feeding. The diffusion of innovations theory was applied, including holding realistic situation workshop of incontinence dermatitis, making graded identification cards, innovating ventilation hood, revising the graded care protocol, and implementing the teamwork of diarrhea procedures. After the intervention, the incidence rate reduced from 15.4% to 3.1%. Therefore, the project goal was achieved. Finally, the result shows that applying innovation diffusion theory can innovate the tools and revise the graded care protocol, thereby improving the quality of skin care through one unit out to other units.