提升嬰幼兒尿布性皮膚炎照護正確率

Improving the Accuracy of Caring for Infant with Diaper Dermatitis

張瑞雲(Rui-Yun Chang)；陳怡汝(Yi-Ru Chen)；林昭君(Jhao-Jyun Lin)；呂基燕(Ji-Yan Lyu)；鍾惠君(Hui-Chun Chung)；戴佳惠(Chia-Hui Tai)；鄭雅君(Ya-Chun Cheng)

尿布性皮膚炎 ； 加護病房 ； 嬰兒 ； Diaper dermatitis ； Infant ； Intensive care unit

志為護理-慈濟護理雜誌

20卷6期（2021 / 12 / 01）

96 - 106

繁體中文

尿布性皮膚炎是嬰幼兒最常見的皮膚問題，造成臀部皮膚發紅、破皮及潰瘍疼痛不適，引起家屬抱怨，回溯2019年5月1日至7月31日的病歷資料，住院嬰幼兒共260人，發生尿布性皮膚炎83人，本單位嬰幼兒尿布性皮膚炎發生率為31.9%，顯示此問題之嚴重性，引發改善的動機。結果發現護理師尿布性皮膚炎照護正確率僅52.3%。專案目的期望護理師執行尿布性皮膚炎照護正確率提升至90%。本專案介入措施包括：新增修尿布性皮膚炎照護作業標準；舉辦尿布性皮膚炎在職教育訓練；製作尿布性皮膚炎分級圖卡；制定尿布性皮膚炎高危險評估表；醫院統一提供皮膚防護劑；水槽提供溫水。專案執行後結果尿布性皮膚炎護正確率提升至95.2%，期望透過嬰幼兒尿布性皮膚炎正確照護標準，提供臨床照護參考，提升照護品質。

Diaper dermatitis is the most common skin disorder in infants and toddlers. It causes erythema, erosions, and ulcers on the buttocks. Pain and discomfort are associated symptoms causing parents to complain about the health care. Medical record backtracking from May 2019 to July 2019 with a total of 260 hospitalized infants and toddlers, 83 patients had diaper dermatitis. Moreover, it was found that the average incidence of diaper dermatitis in our unit is 31.9%, indicating the importance of this issue. The high incidence of diaper dermatitis is a major issue and has to be solved. However, the correct rate of nursing care for diaper dermatitis was only 52.3%. This study aimed to increase the accuracy of nursing care for diaper dermatitis of up to 90%. The intervention measures include the following: Developing a new standardized care guideline for diaper dermatitis, holding on-the-job training for diaper dermatitis, making a diaper dermatitis grading scale; formulating/drawing up a diaper dermatitis risk score, and providing skin protection agents and warm water. The correct rate of nursing care for diaper dermatitis had increased to 95.2% after implementation. Using a correct nursing care can provide a clinical care reference and improve the quality of care.

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