Prevention of incontinence-associated dermatitis by standardised nursing based on the guidelines for prevention and control
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摘要:
目的 探究基于ICU失禁相关性皮炎(IAD)防控指引(简称防控指引)的规范化护理对IAD的预防效果。 方法 选取丽水市中心医院ICU 2019年10月—2020年9月期间收治的155例出现尿便失禁患者,根据随机数字表法分为研究组(79例)和对照组(76例)。对照组给予常规护理干预,研究组在对照组基础上给予基于IAD防控指引的规范化护理干预。观察和比较2组患者IAD发生情况、预后、并发症以及护理满意度。 结果 研究组患者IAD总发生率(15.19%)明显低于对照组(34.21%),差异有统计学意义(P<0.05);研究组皮损恢复时间、ICU收治时间、总住院时间为[(2.78±0.56)d、(4.98±0.47)d、(7.52±1.32)d],显著低于对照组[(6.45±1.12)d、(8.46±1.55)d、(9.82±1.97)d],差异均有统计学意义(t=25.950、19.067、8.569,均P<0.01);研究组患者护理总满意度(96.20%)较对照组(67.11%)明显提高,差异有统计学意义(P<0.05)。 结论 针对ICU重症尿便失禁患者实施基于IAD防控指引的规范化护理干预可以有效防控IAD及其相关并发症的发生,加快患者病情恢复,同时提高护理满意度。 Abstract:Objective To explore the preventive effect of standardised nursing based on the clinical guideline for prevention and treatment of incontinence-associated dermatitis (IAD) in the ICU. Methods Between October 2019 and September 2020, 155 patients with urinary and faecal incontinence admitted to the ICU of Lishui Central Hospital were selected. Using the random number table method, they were divided into two groups: study group (79 cases) and control group (76 cases). The control group received routine nursing intervention, whereas the study group received standardised nursing intervention based on the clinical guideline for prevention and treatment of IAD. The occurrence of IAD, prognosis, complications and nursing satisfaction of the two groups were compared. Results The total incidence of IAD in the study group was 15.19%, significantly lower than 34.21% in the control group (P < 0.05). The skin lesion recovery time, length of ICU stay and total length of hospital stay of the study group were (2.78±0.56) days, (4.98±0.47) days and (7.52±1.32) days, significantly shorter than those of the control group [(6.45±1.12) days, (8.46±1.55) days and (9.82±1.97) days, respectively, t=25.950, 19.067, 8.569, all P < 0.01]. The nursing satisfaction of the study group (96.20%) was significantly higher than that of the control group (67.11%, P < 0.05). Conclusion Standardised nursing based on the clinical guideline for prevention and treatment of IAD can effectively prevent and control the occurrence of IAD and its related complications, and speed up the recovery of patients whilst improving nursing satisfaction. -
表 1 2组尿便失禁患者干预后失禁性皮炎发生情况比较[例(%)]
Table 1. Comparison of the incidence of incontinence dermatitis between the two groups of patients with urinary incontinence after intervention [cases (%)]
组别 例数 正常 轻度 重度 重度 研究组 79 67(84.81) 9(11.39) 3(3.80) 0 对照组 76 50(65.79) 7(9.21) 15(19.74) 4(5.26) 注:2组失禁性皮炎严重程度比较,Z=9.600,P=0.002。 表 2 2组尿便失禁患者恢复进程比较(x±s, d)
Table 2. Comparison of the recovery process of 2 groups of patients with urinary incontinence (x±s, d)
组别 例数 皮损恢复时间 ICU收治时间 总住院时间 研究组 79 2.78±0.56 4.98±0.47 7.52±1.32 对照组 76 6.45±1.12 8.46±1.55 9.82±1.97 t值 25.950 19.067 8.569 P值 <0.001 <0.001 <0.001 表 3 2组尿便失禁患者并发症发生情况比较[例(%)]
Table 3. Comparison of complications in patients with urinary incontinence in two groups [cases (%)]
组别 例数 单一并发症 多种并发症 总发生 压力性损伤 真菌性皮炎 尿路感染 研究组 79 0 1(1.27) 1(1.27) 0 2(2.53) 对照组 76 3(3.95) 6(7.89) 3(3.95) 0 12(15.79) 注:2组并发症总发生率比较,χ2=8.287,P=0.004。 表 4 2组尿便失禁患者护理满意度比较[例(%)]
Table 4. Comparison of nursing satisfaction of two groups of patients with urinary incontinence [cases (%)]
组别 例数 非常满意 满意 不满意 总满意度 研究组 79 37(46.84) 39(49.37) 3(3.80) 76(96.20) 对照组 76 22(28.95) 29(38.16) 25(32.89) 51(67.11) 注:2组总满意度比较,χ2=22.157,P<0.001。 -
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