降低加護病房病人失禁性皮膚炎之發生率

Reducing Incidences Rate of Incontinence Associated Dermatitis in the Intensive Care Unit Patients

李筱薇(Hsiao-Wei Lee) ； 胡瑞桃(Shui-Tao Hu)

《長期照護雜誌》 16卷2期 (2012/09) Pp. 191-204

https://doi.org/10.6317/LTC.201209_16(2).0007

摘要

皮膚完整性為照護過程主要目標，針對某教學醫院加護病房2009年1月至10月，失禁性皮膚炎發生率16.4％，2009年11月及12月發生率分別19.1％及32.8％，顯示逐月上升。鑑此，自2010年1月1日至2月28日間成立專案小組，包括醫護人員及營養師，針對失禁性皮膚炎原因進行資料收集，原因顯示病人皆著尿布、床墊外防水中單多層次鋪設（皮膚潮濕度高）、失禁性皮膚炎護理標準不完整、缺乏專科品質監控、護理人員認知偏低等項目。擬定降低加護病房病人失禁性皮膚炎改善方案，包括減少著尿布、塑膠薄膜取代防水中單鋪設、增修護理標準、增設專科品質監控及舉辦教育課程等措施，主要目的為降低失禁性皮膚炎發生率，依據機構內專科品質指標低於6.6％，方案介入後結果顯示：（1）失禁性皮膚炎發生率由32.8％降至5.4％；（2）護理人員對失禁性皮膚炎認知由56.2％提升至100.0％，達目標值6.6％以下，期望透過失禁性皮膚炎病人正確照護標準，提供相關單位護理人員照護參考。

關鍵字

發生率 ； 失禁性皮膚炎 ； 加護病房病人

並列摘要

A complete skin care is one of the goals of nursing care. The incidence rate of incontinence associated dermatitis was 16.4% at an intensive care unit in a teaching hospital from January to October 2009. Incontinence associated dermatitis incidences were 19.1% and 32.8%, indicating increased month by month, between November and December 2009. According to the preliminary analysis from January 1 to February 28, 2010, the teamwork was set up to collect and assesses causes of incontinence associated dermatitis, which the major causes for patients all diapers wearing and multi-ladder waterproofing sheet using (skin high moisture). In addition, the causes of incontinence associated dermatitis also included inadequate standards care, lack of quality control, and insufficient knowledge for nursing staff of incontinence associated dermatitis. The teamwork developed an improvement project to decrease the prevalence rate of incontinence associated dermatitis. The project included reduced diapers using, plastic sheet to replace multi-ladder waterproof sheet, modify nursing standards, set quality control, and arrange nursing educational courses. The result after the project intervention showed that: (1) the incidence rate of incontinence associated dermatitis decreased from 32.8% to 5.4%, which achieved the target set at 6.6%. (2) incontinence associated dermatitis cognition of nurses increased from 56.2% to 100%. Therefore, the results should be provided to nurses as a reference for incontinence associated dermatitis patients' care.

並列關鍵字

incidence rate ； incontinence associated dermatitis ； intensive care unit patients