{"title":"降低重症监护病房失禁相关皮炎的发病率：质量改进项目。","authors":"Yi Chen, Lan Gu, Yan Lu, Wei Ding, SiMin Cheng","doi":"10.1016/j.jtv.2024.09.010","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Patients in the intensive care unit (ICU) are at a high risk of developing incontinence-associated dermatitis (IAD), the incidence and severity of which are positively related to pressure injuries, thus affecting nursing quality indicators. 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引用次数: 0
摘要
目的：重症监护病房（ICU）的患者极易患上失禁相关皮炎（IAD），其发病率和严重程度与压力损伤呈正相关，从而影响护理质量指标。该质量改进项目旨在降低 IAD 的严重程度和发病率，重点是提高护理人员的认识：设计：该项目为期 36 个月，通过 "计划-实施-研究-行动"（PDSA）模式实施：方法：质量改进项目包括三个主要程序，分别是 "计划-实施-研究-行动"（PDSA）模式和 "改进-实施-研究"（PDSA）模式：质量改进项目包括三个主要程序：(1）制定并实施会阴通气早期结构化皮肤护理改良防治护理方案，制定失禁护理指导单；（2）组织理论和技能培训与考核，包括失禁护理培训（理论知识、项目流程、视频观看）、护理人员技能培训、失禁护理工作坊三个专场，全员参与并考核；（3）年度护理质控分析与讨论：项目完成后，IAD 的总体发生率有所下降。此外，ICU 护士对 IAD 的重视程度/意识也有所提高：该项目成功降低了 ICU 患者的 IAD 发生率。
Decreasing the rate of incontinence-associated dermatitis in intensive care units: A quality improvement project.
Purpose: Patients in the intensive care unit (ICU) are at a high risk of developing incontinence-associated dermatitis (IAD), the incidence and severity of which are positively related to pressure injuries, thus affecting nursing quality indicators. This quality improvement project aimed to decrease the severity and incidence of IAD, with a focus on enhancing awareness among nursing staff.
Design: This 36-month project was implemented via the Plan-Do-Study-Act (PDSA) model.
Subjects: and setting: Included staff members worked in the ICUs (central and emergency ICUs) at a Grade A tertiary hospital in Suzhou (South of Jiangsu), China.
Methods: The quality improvement project included three main procedures: (1) formulating and implementing a modified prevention and treatment nursing protocol for early structured skin care with perineum ventilation, formulating a guidance sheet for incontinence nursing care; (2) organizing training and assessments of theories and skills, including three special sections on incontinence care training (theoretical knowledge, project process, video watching), skills training for nursing staff, and an incontinence nursing workshop to engage and evaluate all staff; (3) annual analysis and discussion of nursing quality control.
Results: Following project completion, there was a decrease in the overall incidence of IAD. Moreover, ICU nurses may attach more importance/awareness to IAD.
Conclusions: This project successfully reduced the incidence of IAD among ICU patients.
期刊介绍：
The Journal of Tissue Viability is the official publication of the Tissue Viability Society and is a quarterly journal concerned with all aspects of the occurrence and treatment of wounds, ulcers and pressure sores including patient care, pain, nutrition, wound healing, research, prevention, mobility, social problems and management.
The Journal particularly encourages papers covering skin and skin wounds but will consider articles that discuss injury in any tissue. Articles that stress the multi-professional nature of tissue viability are especially welcome. We seek to encourage new authors as well as well-established contributors to the field - one aim of the journal is to enable all participants in tissue viability to share information with colleagues.
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