提升失禁性皮膚炎癒合率專案

背景：失禁性皮膚炎為臨床重症病人常見、高成本之照護問題。其發生原因複雜，例如：護理人員缺乏教育訓練、皮膚清潔劑應用認知不足、未制定照護標準及監測流程、無相關教材可供查閱、未設置相關設備等因素。現況調查本院單位失禁性皮膚炎之癒合率低（14％），容易導致病患進而發生感染。目的：透過本專案建立全面改善措施，有效提升失禁性皮膚炎癒合率至90％以上。方法：本專案全面改善措施，包括：建立照護標準；製作流程海報與皮膚評估圖卡；設置結構式皮膚照護組合包；進行情境模擬教育訓練及完成多媒體（含QR code）教材等策略。結果：本專案執行後的成效評值發現癒合率明顯提升至93.3％，癒合天數由平均22天縮短至6天。結論：藉由本全面改善措施專案，可以有效提升失禁性皮膚炎的癒合率，並縮短癒合天數。

關鍵字

皮膚炎；癒合率；人形圖；失禁；專案

並列摘要

Background: Incontinence-associated dermatitis (IAD) appears frequently and costly in the clinical care among critically ill patients. The factors related to incontinence-associated dermatitis is complicated, such as insufficient education and training for nursing staff; lack of knowledge of the application of skin cleansers and standard operation procedure (SOP) of care and monitor procedure; lack of relevant and teaching materials when needed; inadequate resources and equipment to support a proper nursing care etc. Our survey found that the healing rate of incontinence-associated dermatitis is low (14%), with increasing risk of infection. Objective: This project aimed to improve the healing rate of incontinence-associated dermatitis higher than 90%. Methods: We designed comprehensive measures to improve the healing rate of incontinence-associated dermatitis: establishing SOP of care and monitor procedure through the use of poster for skin care procedure and skin evaluation card; establishing the skin-care material bundle; conducting training program using scenario simulation, and producing multi-media learning materials with the use of QR code for dissemination. Results: Outcome evaluation of the care improvement found that the recovery rate was increased from 14% to 93% and the days of healing process was decreased from 22 to six days. Conclusion: This project successfully improved the healing rate and shortened the healing process of incontinence-associated dermatitis.

並列關鍵字

Dermatitis ； Healing rate ； Human figure ； Incontinence ； Project

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