提升護理師對醫療黏性產品相關皮膚損傷之預防照護能力

Improvement of the Care Ability of Nurses for Preventing Medical Adhesive-Related Skin Injuries

10.6320/FJM.202211_26(6).0011

蕭薇玫(Wei-Mei Hsiao)；吳靜怡(Jing-Yi Wu)；許曉萍(Hsiao-Ping Hsu)

醫療黏性產品相關皮膚損傷 ； MARSI盛行率 ； MARSI預防 ； medical adhesive-related skin injury ； prevalence of MARSI ； prevention of MARSI

台灣醫學

26卷6期（2022 / 11 / 25）

720 - 730

繁體中文

本專案意旨在提升護理師對醫療黏性產品相關皮膚損傷（medical adhesive-related skin injury, MARSI）之照護能力，動機係本單位因醫療黏性產品導致皮膚損傷，進而造成病人抱怨及增加醫療成本，經分析導因：護理師對MARSI預防照護能力不足。透過發展「高危MARSI病人評估表」評估機制、製作「MARSI預防照護標準作業流程、MARSI高危個案警示卡及預防MARSI之教學海報」、培訓種子人員及舉辦教訓練等策略，護理師對MARSI預防照護之認知及行為正確率，由35.7%及21.9%提升至96.3%及93.8%；期間單位MARSI點盛行率從61.3%降至8.1%，成效良好。建議未來平行推廣，以促進病人安全及照護品質。

This program aims to improve the care ability of nurses for medical adhesive-related skin injury (MARSI). This research was conducted to prevent skin damage due to medical adhesive-related skin injury, which in turn causes complaints from patients and increases medical costs. After cause analysis, the major cause was that the nurses have insufficient ability of MARSI preventive care. The intervention included establishing the ＂high-risk MARSI patient assessment form＂, ＂MARSI preventive care standard operating procedures, MARSI high-risk case warning cards and MARSI prevention teaching posters＂, training seed personnel, and holding education training strategies. The accuracy of nurses' MARSI knowledge and care behavior increased from 35.7% and 21.9% to 96.3% and 93.8%. During the study period, the prevalence rate of MARSI points per unit dropped from 61.3% to 8.1%, suggesting favorable program outcome. Therefore, we recommend disseminating these strategies to other units to improve patient safety and to enhance the quality of care.

1. 許淑盆、黃建賢、賴寶琴等：重症病人醫療黏膠相關皮膚損傷之改善成效。台灣醫學2016;5:456-9。 doi: 10.6320/FJM.2016.20(5).2
   連結：
2. Farris MK, Petty M, Hamilton J, et al. Medical adhesive-related skin injury prevalence among adult acute care patients. JWOCN 2015;42:589-98. doi: 10.1097/WON.0000000000000179
   連結：
3. Fumarola S, Allaway R, Callaghan R, et al. Overlooked and underestimated: Medical adhesive-related skin injuries. JWC 2020;29:S1-24. doi: 10.12968/jowc.2020.29.Sup3c.S1
   連結：
4. Kelly-O’Flynn S, Mohamud L, Copson D. Medical adhesive-related skin injury. Br J Community Nurs 2020;29:S20-6. doi: 10.12968/bjon.2020.29.6.S20
   連結：
5. Hampton S. Medical adhesive related skin injury: Methods of prevention. NRC 2020; 22:148-54. doi: 10.12968/nrec.2020.22.3.148
   連結：
6. Serra R, Ielapi N, Barbetta A, et al. Skin tears and risk factors assessment: A systematic review on evidence-based medicine. Int Wound J 2018;15:38-42. doi: 10.1111/iwj.12815
   連結：
7. Zeng LA, Lie SA, Chong SY. Comparison of medical adhesive tapes in patients at risk of facial skin trauma under anesthesia. Anesthesiol Res Pract 2016;2016:4878246. doi: 10.1155/2016/4878246
   連結：
8. Vanzi V, Toma E. How to prevent and avoid common mistakes in skin tear management in the home setting. Br J Community Nurs 2017;22:S14-9 doi: 10.12968/bjcn.2017.22.Sup9.S14
   連結：
9. Hadfield G, De Freitas A, Bradbury S. Clinical evaluation of a silicone adhesive remover for prevention of MARSI st dressing change. Br J Community Nurs 2019; 33:36-41.
10. McNichol L, Lund C, Rosen T. Medical adhesives and patient safety: State of the science: consensus statements for the assessment, prevention, and treatment of adhesive-related skin injuries. JWOCN 2013; 40:365-380.