失禁相关性皮炎的护理研究进展

失禁相关性皮炎是指皮肤长时间或反复暴露于尿液或粪便中所造成的皮肤炎症反应,不仅对患者造成痛苦,降低其生活质量,还使其经济负担加重。故本文旨在总结失禁相关性皮炎的流行病学特征、危险因素及护理研究进展,以提高护理人员对失禁相关性皮炎的认识,为作好失禁相关性皮炎预防和管理提供依据。     

前瞻性护理干预用于ICU失禁患者失禁相关性皮炎防治中的效果

目的:探讨前瞻性护理干预用于ICU失禁患者失禁相关性皮炎防治中的效果.方法:将在本院接收治疗的ICU失禁患者86例作为研究对象进行随机分组,均为2016年7月至2017年7月期间收治,对照组43例患者实施传统相关性皮炎防治护理干预,观察组43例患者采用前瞻性相关性皮炎防治护理干预,观察比较两组患者失禁相关性皮炎的发生率及护理满意度.结果:观察组患者失禁相关性皮炎发生率13.95％ 显著低于对照组44.19％,护理满意度评分显著高于对照组,数据比较差异均具有统计学意义(P<0.05).结论:将前瞻性护理干预应用在ICU失禁患者失禁相关性皮炎防治具有显著的效果,利于降低发生率,并提高患者护理满意度,值得推广.     

危重症患者应用预防失禁相关性皮炎护理流程的效果

目的:探讨危重症患者应用预防失禁相关性皮炎护理流程的效果.方法:选取我院临床接诊的危重症患者86例,并将患者按照随机数字表法分成护理组、对照组,每组各43例.对照组实施常规失禁护理,护理组在对照组基础上应用预防失禁相关性皮炎护理流程干预.干预后,对两组患者的失禁相关性皮炎的发病率及严重程度(IADS)进行比较.结果:干预后,护理组患者IAD发病率比对照组低(P<0.05);护理组患者IAD发生时间及IADS评分均明显优于对照组(P<0.05).结论:对危重症患者实施预防失禁相关性皮炎护理流程干预可显著改善其IAD发生时间及严重度,有效降低其IAD的发生率,值得临床推广应用.     

品管圈活动对失禁性皮炎患者的护理干预效果评价

目的研究对失禁性皮炎患者实施品管圈活动措施的应用效果。方法选取本院120例失禁性皮炎患者分为常规组与干预组各60例。常规组实行一般护理措施,干预组实施品管圈活动措施,观察比较两组临床疗、护理满意度和生存质量情况。结果干预组临床总有效率显著高于常规组;干预组护理满意度各项评分均显著高于常规组;干预组生存质量各项评分均显著高于常规组;差异具有统计学意义(P<0.05)。结论对失禁性皮炎患者实施品管圈活动护理干预措施,可取得良好的治疗效果,提高患者对护理服务的满意度,提高患者的生存质量。     

综合护理干预预防ICU失禁性皮炎的临床观察

目的:评价综合护理干预预防ICU失禁性皮炎(IAD)效果.方法:医院ICU收治的80例患者作为研究对象,将患者随机分为对照组、观察组,各40例,对照组及时清理失禁粪液,以纸吸干会阴、肛周,涂抹锌氧油、百多邦或造口护肤粉,观察组进行综合护理干预,对护士进行培训,从避免皮肤与刺激物长期接触、皮肤清洗、皮肤滋润、皮肤保护四个角度进行护理干预.结果:观察组IAD发生率20.0%,对照组发生率52.0%,观察组ICU停留期间PAT均值、IAD发生后严重程度评分峰值低于观察组,IAD发生时间晚于对照组,差异具有统计学意义(P<0.05).结论:综合护理干预可有效降低ICU中IAD发生风险.     

Braden评分对失禁患者发生失禁相关性皮炎的预测价值

目的分析Braden评分对住院患者发生失禁相关性皮炎的预测价值,为制订护理方案提供依据。方法采用Braden量表及失禁相关性皮炎评估量表评估191例住院失禁患者。结果 191例患者中有25例(13.09%)发生失禁相关性皮炎。其中压疮低危人群29例,发生失禁相关性皮炎5例;压疮中危人群30例,发生失禁相关性皮炎8例;压疮高危人群132例,发生失禁相关性皮炎12例。随着Braden评分降低,失禁相关性皮炎发生率明显增加(P<0.05)。失禁相关性皮炎患者的感知能力、潮湿度和移动能力评分均低于非失禁相关性皮炎患者(P<0.05)。Braden评分中,潮湿度、感知能力是发生失禁相关性皮炎的直接影响因素(P<0.05)。结论 Braden评分能够预测失禁患者失禁相关性皮炎的发生,科学地使用Braden量表可有效预防失禁相关性皮炎的发生,为临床制订预见性护理方案提供一定的依据。     

程序化肛周护理在ICU失禁性皮炎的应用

目的:探讨程序化肛周护理模式对ICU失禁性皮炎患者的应用效果.方法:选择ICU年龄18岁及以上大便失禁的患者178例,随机抽样法分成对照组85例和实验组93例.对照组给予常规干预方法,实验组给予程序化肛周护理,统计两组失禁性皮炎发生率情况.结果:实验组发生率为9.68％,对照组发生率为29.41％,实验组明显低于对照组(P<0.01).结论:对ICU失禁患者给予程序化肛周护理有助于防止失禁性皮炎发生,提高ICU皮肤护理质量,值得临床推广.     

ICU人工气道患者实施集束化护理效果分析

目的分析ICU人工气道患者实施集束化护理模式的临床效果。方法将136例ICU 人工气道患者平均分成研究组和对照组。对照组按ICU一般护理模式进行护理;研究组实施集束化护理模式。对比两组意外脱管及肺部感染的发生情况。结果研究组无意外脱管病例出现且肺部感染的发生率较低。结论 ICU人工气道患者实施集束化护理模式的临床疗效令人满意。     

集束化护理在预防血液透析导管相关血流感染的效果分析及护理体会

目的:探究对血液透析患者实施集束化护理在预防导管相关血流感染(CRBSI)的效果。方法:对2019.6~2020.2在本院血透中心进行血液透析治疗的82例患者进行研究,随机分为对照组(常规护理)41例、研究组(集束化护理)41例,观察患者CRBSI发生情况。结果:研究组导管留置时间短于对照组(P<0.05);研究组CRBSI发生率为2.44%,低于对照组14.63%(P<0.05)。结论:在血液透析中应用集束化护理能够缩短导管留置时间,减少CRBSI的发生,取得良好的护理效果。     

集束化护理干预ICU综合征效果评价

目的评价集束化护理措施干预ICU综合征的效果。方法选取2015年1月—2016年6月收治的110例患者作为研究对象,按照随机数表法分为对照组和干预组,各55例,对照组采用常规护理,干预组采用集束化护理措施,对比两组谵妄发病率、睡眠质量、谵妄持续时间、平均住院时间和患者满意度。计量资料采用t检验,计数资料采用χ~2检验,P0.05为差异有统计学意义。结果对照组意识发生改变的比例高于干预组,治疗后的第3天、5天干预组PSQI评分低于对照组,干预组谵妄发病率、谵妄持续时间、平均住院时间均低于对照组,患者满意度较高。结论集束化护理干预策略能有效降低患者谵妄发生率、谵妄持续时间、住院平均时间,提高患者睡眠质量和护理满意度,为早期发现、干预ICU综合征提供新的途径。     

集束化护理干预对重症急性胰腺炎患者的临床及护理质量的影响

目的 探讨集束化护理干预在重症急性胰腺炎患者中的应用效果及对护理质量的影响。方法 选取2017年4月—2018年5月在我院进行治疗的重症急性胰腺炎患者96例,按照随机数字表法的分组方法,将其分为对照组和观察组,每组各48例。对照组患者采用常规护理干预,观察组患者采用集束化护理干预,观察分析患者的腹痛消失时间、发热持续时间、平均住院时间及护理满意程度。结果 观察组患者腹痛消失时间、发热持续时间及平均住院时间(5.63±1.12、3.68±0.52、17.59±2.67)均低于对照组(9.31±3.25、6.84±1.73、24.18±4.20),差异有统计学意义(t=7.417、12.119、9.174,P均=0.000);护理后,观察组患者护理满意程度(95.83%)均高于对照组(64.58%),差异有统计学意义(t=14.764,P=0.000)。结论 对重症急性胰腺炎患者给予集束化护理效果较好,可有效促进患者的病情康复,使护理质量得到提升。     

Implementation of a nursing home urinary incontinence management program with and without tolterodine

OBJECTIVE: To evaluate the implementation of a nursing home urinary incontinence management program. DESIGN: A prospective field trial of the program incorporating practice guidelines and principles of continuous quality improvement. SETTING: Five nursing homes in New York, Virginia, and Georgia PARTICIPANTS: One hundred fifty-one residents identified as being incontinent of urine and who met inclusion criteria for ongoing participation in the program. INTERVENTION: Key multidisciplinary staff from the five nursing homes were trained in the program and assumed responsibility for implementing it in their facilities. The program consisted of a clinical assessment, toileting protocols, and the addition of the antimuscarinic drug tolterodine in selected residents who did not respond well to toileting alone. Data on dryness rates during the 60-day toileting protocols, collected by nursing home staff, were analyzed on a weekly basis by an overall project coordinator who sent data back to the nursing homes in an easy-to-read graphical format. MEASURES: (1) The dryness rate, defined as the number of times the resident was dry divided by the number of times the resident was checked (every 2 hours from 7 a.m. to 7 p.m.); and (2) adverse events (eg, dry mouth, increased confusion, need for dosage reduction). RESULTS: Of 645 residents in the 5 nursing homes, 377 (58%) were identified as incontinent of urine, of whom 151 (40%) were placed on an ongoing toileting program. Of these 151 residents, 48 (32%) were prescribed tolterodine, and 117 (78%) completed the 60-day trial. The initial dryness rate was 57%, and for the group as a whole remained essentially unchanged (increase in dryness 1%, P = 0.50). Among 50 clinically stable residents on a toileting program alone, the increase in the dryness rate was 16% (P = 0.001), and for 31 clinically stable residents prescribed tolterodine, the increase in the dryness rate was 29% (P = 0.012). Two residents had their dosage of tolterodine reduced because of dry mouth and nausea,one resident was taken off the drug because of increased pain in the back and legs and increased confusion. CONCLUSIONS: Overall, this program resulted in significant increases in dryness rates for clinically stable incontinent nursing home residents. These residents represented 22% of the total number of residents identified as incontinent in the five participating nursing homes. Tolterodine was prescribed for approximately one-third of incontinent residents as a supplement to a toileting program, and was well tolerated. Nursing homes should be encouraged to implement similar urinary incontinence programs, target toileting protocols to the most responsive residents, and maintain the program using principles of continuous quality improvement.     

Oral ddAVP for nighttime urinary incontinence in characterized nursing home residents: a pilot study

OBJECTIVES: To (1) identify abnormalities in arginine vasopressin (AVP, a water-conserving hormone) secretion and release in nursing home (NH) residents with nighttime urinary incontinence (UI); and (2) perform a pilot test of desmopressin acetate (ddAVP, a synthetic analog of the naturally occurring hormone) replacement in these residents. DESIGN: Diagnostic evaluation and open-label treatment trial. SETTING: Two community nursing homes in a metropolitan area. PARTICIPANTS: Male and female NH residents 65 years of age and older with nighttime UI. INTERVENTION: Characterizations of AVP status followed by a 7-day open-label trial of oral ddAVP (either 0.1 mg or 0.2 mg). MEASUREMENTS: Water deprivation test results, AVP levels, voided volumes, number of voids, incontinent episodes, number of nighttime checks found wet (out of 6 total checks per night). RESULTS: All participants had measurable AVP levels of 2.0 pg/mL or higher. Six of 10 individuals had an abnormal water deprivation test. Two of 4 participants on 0.2 mg of ddAVP and 2 of 6 participants on 0.1 mg had a 200 mL or more mean reduction in nighttime urine volume. Both ddAVP dosages yielded a mean reduction of 0.7 fewer nighttime wet checks found wet. One participant in each group developed hyponatremia (1 of 6 on 0.1 mg and 1 of 4 on 0.2 mg). Hyponatremia resolved with discontinuation of the drug. CONCLUSION: Both 0.1 mg and 0.2 mg of ddAVP given to carefully screened NH residents for 7 days produced a modest average reduction in nighttime urine volume and number of nighttime incontinent episodes that is likely of little clinical importance. The role of ddAVP in this population requires further research.     

循证护理在经尿道前列腺电切术后尿失禁中的应用

目的：探讨循证护理在经尿道前列腺电切术后尿失禁中的应用效果。方法：选择从2012年12月~2014年12月在安徽医科大学第一附属医院进行治疗的经尿道前列腺电切术后尿失禁患者100例,以50例为1组,随机分为观察组和对照组,对照组行常规护理,观察组行循证护理。观察并对比两组的应用效果。结果：观察组住院时间低于对照组,比较差异具有统计学意义(P<0.05);观察组满意度分布优于对照组,比较差异具有统计学意义(P<0.05);干预前两组患者的前列腺症状评分无显著差异(P>0.05),干预后两组组内、组间比较差异均有统计学意义(P<0.05)。结论：采用循证护理可显著降低患者的住院时间,提升护理满意度,缓解前列腺症状,具有较高的应用价值。     

集束化护理方案预防呼吸机相关性肺炎的效果观察

目的 探讨集束化护理方案在预防呼吸机相关性肺炎(VAP)的效果,为临床治疗提供参考.方法 选取2010年1-12月收住ICU的176例机械通气≥48 h患者为集束化组,患者均采取抬高床头30～45度、持续声门下吸引、密闭式吸痰、人工鼻的应用、加强口咽部管理、严格洗手等集束化护理干预措施,选取2009年1-12月ICU收治的163例机械通气≥48 h患者为对照组,比较两组患者VAP发生率、机械通气时间、ICU住院时间及痰病原学检查结果.结果 与对照组相比,采用集束化护理方案后VAP发生率由25.15％降至15.91％,差异有统计学意义(P＜0.05);机械通气时间由(13.5±5.6)d缩短至(8.5±4.2)d,差异有统计学意义(P＜0.05),ICU住院时间由(21.17±17.62)d缩短至(13.42±9.23)d,差异有统计学意义(P＜0.01);两组患者病原菌均以革兰阴性菌为主,差异无统计学意义.结论 集束化护理方案对预防VAP有着重要的意义,加强对医护人员的培训,提高集束化护理方案的依从性和完善的质量控制是降低VAP的关键.     

急诊心理护理对急诊患者护理效果的影响分析

目的:评析急诊患者应用心理护理对于提升护理效果的作用.方法:选取我院2019年2月至2020年2月接诊的急诊患者98例,使用抽签法分为对照组(方法:常规护理)和观察组(方法:急诊心理护理),每组各49例,对比两组急诊患者的整体护理效果.结果:观察组收缩压(125.36±11.52)mmHg、舒张压(82.54±4.64...     

在手术室护理中运用舒适护理的体会

目的:探讨舒适护理在手术室中的重要作用,进而使患者安全、舒适地接受手术。方法:在患者中选择100名作为研究小组,分为两个组别,有实验组和对照组,实验组为舒适护理的,对照组为普通护理。结果:实验组患者生理、心理等方面均有改善,术后随访满意度98%,高于对照组的85%。结论:舒适护理能够加强手术患者的安全,提高护理质量。     

A health related quality of life measure for use in patients with urge urinary incontinence: A validation study

Objective: Urge incontinence has substantial impact on health related quality of life (HRQOL). The purpose of this research was to test the psychometric properties of the Urge-Incontinence Impact Questionnaire (U-IIQ) and Urge-Urinary Distress Inventory (U-UDI). Methods: The U-IIQ and the U-UDI were incorporated in a single arm study of an investigational once-a-day formulation of oxybutynin (Ditropan^® XL) for urge incontinence. The U-IIQ contains 7 scales scored separately: Travel, Activities, Physical activities, Feelings, Relationships, Sexual function and Nighttime bladder control. We also calculated a single index score. The U-UDI contains 9 items summarized in a single score that measures the extent to which incontinence symptoms bother patients and an urge symptoms summary score. Patients completed the questions at: start of baseline week, end of baseline week, week 4 and week 12 (final dose). Results: The questions were completed by the 257 patients enrolled in the study (91% female, mean age = 60 years). All item responses showed good variability. Internal-consistency reliability was very good (Cronbach's = 0.82–0.96). Test–retest reliability was good for all scales ([ICC] = 0.68–0.83). Discriminant validity was noted for all scales for patients with and without frequent incontinence (p 0.006 all scales). All scales demonstrated responsiveness to change over time (Guyatt's statistic = |–1.04| – |–1.71|). Conclusions: Psychometric testing indicated that the scales measured distinct and relevant domains of HRQOL for patients with urge incontinence, and that these two instruments are reliable, valid, and responsive to change in this condition.     

集束化循证护理在冠心病患者经PCI治疗围手术期中的构建及应用

目的 探讨集束化循证护理在冠心病患者经皮冠状动脉介入治疗(PCI)围手术期中的构建及应用效果.方法 选取2019年1月-2019年6月在我院心内科进行经皮冠状动脉介入治疗的162例冠心病患者作为本次研究对象.并将本次研究对象按随机数字表法随机分为对照组以及实验组(各81例).其中对照组实施传统常规护理,实验组实施集束化...     

集束护理预防腹泻患者肛周皮炎的应用研究

目的探讨集束护理应用于预防腹泻患者肛周皮炎的临床效果。方法选择62例腹泻患者随机分成两组,其中观察组35例采用集束护理干预,对照组27例采用呋喃林炉甘石洗剂外用涂抹法护理干预,观察并对比两组肛周皮炎的发生率、严重程度及愈合时间。结果观察组肛周皮炎的发生率为8.57%,对照组为37.02%,两组比较P<0.05,且肛周皮炎愈合的时间亦明显少于对照组(P<0.05)。结论集束护理可明显降低腹泻患者肛周皮炎的发生率,减轻肛周皮炎的严重程度,缩短皮炎愈合时间。