提昇護理人員對成人失禁性皮膚炎之照顧能力

Increasing Nurses’ Competence in Caring for Adult Patients with Incontinence Dermatitis

失禁性皮膚炎是臨床上成人皮膚破損的主因之一，因此護理人員對其評估並提供適當照護是必要的。本病房經現況分析後發現：因腹瀉導致失禁性皮膚炎的發生率為45%，推究其主要原因為護理人員對失禁性皮膚炎照護認知不足、未主動評估病患臀部皮膚狀況、單位缺乏失禁性皮膚炎評估單與照護準則和未能提供照顧者相關衛教。本專案目的在提升護理人員照護失禁性皮膚炎的能力，並降低單位失禁性皮膚炎的發生率。解決方案包括：一、藉由設計失禁性皮膚炎評估／照護準則和推行在職教育，提升護理人員對失禁性皮膚炎照護之正確率；二、利用失禁性皮膚炎照護指導單，教導照顧者有關臀部皮膚的照護，以降低失禁性皮膚炎的發生率。方案執行六個月後，護理人員執行失禁性皮膚炎照護正確率由6.2%提升至93%，且發生率由45%降至21%，達成專案目的。本專案結果未來可在各病房推廣，以降低成人失禁性皮膚炎的發生率。

Incontinent dermatitis is one of the major causes in adult skin damage. It is crucial for nurses to assess and to provide adequate care for patients with incontinent dermatitis. According to the preliminary analysis, the prevalence rate of incontinent dermatitis was 45% in an inpatient unit. The major causes of incontinent dermatitis included insufficient knowledge of nurse staff, lack of assessing patients’ skin condition periodically, and lack of adequate skin care policy and procedure in this unit. The purposes of this project were to enhance staff nurses’ competences in caring for incontinent dermatitis and to decrease the prevalence rate of incontinent dermatitis. Strategies used in this study included; 1) to establish the nursing care standards and conduct continuous education course for improving nurses’ competences in caring for incontinent dermatitis; 2) to design a caring guideline for caregivers in how to take care of incontinent dermatitis patients. After 6 months intervention period, the rate of providing adequate nursing care to patients with incontinent dermatitis among nurses increased from 6.2% to 93%. The prevalence rate of incontinent dermatitis decreased from 45% to 21%. The strategies can be implemented in other hospital settings to decrease the occurrence of incontinent dermatitis.