多发性骨髓瘤患者失禁相关性皮炎预防和护理的循证实践

目的 结合1例临床多发性骨髓瘤患者,探讨如何对多发性骨髓瘤失禁相关性皮炎(IAD)进行循证护理.方法 根据患者情况针对性提出临床问题,并按PICO 原则进行转化?检索2006年1月1日至2016年12月31日美国指南网(NGC) ?Cochrane 系统评价资料库(CDSR) ?Medline和PubMed 等数据库,搜集预防与护理IAD 的高质量临床证据?结果 纳入临床实践指南3篇?专家意见1篇?系统评价3篇和随机对照试验(RCT)3篇?根据最终检索结果并结合患者病情和意愿,适当应用吸收性产品,及时清理污染皮肤;同时选择一次性无纺布配合Ph 平衡的皮肤清洁剂温和清洗皮肤;基于清洁?保湿?皮肤保护原则,优先选择三合一失禁护理湿巾或Cavilon 透明保护膜等优势产品并定期评估?结论 运用循证证据能针对性地为患者提供个体化护理方案,从而降低IAD 发生率.

Evidence-based practice on prevention and nursing care of incontinence related dermatitis in patients with multiple myeloma

Objective To explore how to carry out the evidence-based nursing care on multiple myeloma(MM)patients with incontinence associated dermatitis(IAD)by combining with a case of MM in clinic.Methods According to the patient′s situation, the clinical questions were pertinently put forward and converted according to the principle of PICO.And then some databases such as NGC,CDSR,Medline and PubMed were retrieved from January 1,2006 to December 31,2016 for collecting high-quality clinical evidences of the prevention and nursing care of IAD.Results Three clinical practice guidelines,1 expert opinion,3 systematic re-views and 3 RCT were included.According to the final retrieval results and combining with the patient′s condition and wish,the ab-sorbent products were appropriately used,and the contaminated skin was cleaned in time;at the same time the disposable non-woven fabric coordinated with pH balanced skin cleanser was selected to clean skin gently.Based on the principles of cleaning,preserving moisture and skin protection,some superior products,such as 3-in-1 incontinence care wipes or Cavilon transparent protective film, were given priority to select and regularly evaluated.Conclusion Applying the evidence-based evidence can pertinently provide the individualized nursing scheme for the patients,thus reduces the incidence rate of IAD.