外科加護病房醫療黏性相關皮膚損傷發生率之改善專案

Reducing the Incidence of Medical Adhesive-Related Skin Injuries in Surgical Intensive Care Unit

背景：重症病人常因使用醫療黏性產品黏貼及撕除時不注意，而造成醫療黏性相關皮膚損傷（medicaladhesive-related skin injury, MARSI），其後續影響甚鉅。期望透過專案改善降低皮膚損傷發生率，增進重症照護品質。目的：旨在降低外科加護病房醫療黏性相關皮膚損傷發生率及提高預防照護正確率。解決方案　介入措施涵蓋設計產品圖示卡、高風險警示標語、舉辦在職教育、拍攝MARSI預防教育影片、體驗工作坊及建構預防MARSI照護標準。結果：2017年11月至2018年4月醫療黏性相關皮膚損傷發生率由前測18.2％下降至後測0％－9.3％，預防照護平均正確率由38.6％提升至95.5％。結論：專案推行後降低重症病人皮膚損傷，提升重症照護品質，MARSI照護及預防技巧也納入傷口換藥護理標準內容，並平行推展至全院，讓皮膚照護更加完善。

Background & Problems: Patients with critical illnesses face an elevated risk of medical adhesive relation skin injuries (MARSI), which have negative, subsequent impacts on recovery and quality of healthcare. Purpose: The aim of this project was to decrease the incidence of MARSI in the surgical intensive care unit and to improve the accuracy of MARSI preventive care implementation. Resolutions: The intervention included the implementation of product-use cards, high-risk warning slogans, education programs, experience workshops, and a standard prevention-care protocol for MARSI. Results: After project implementation, the incidence rate of MARSI decreased from 18.2% to 0%-9.3%, and the accuracy rate of preventive care increased from 38.6% to 95.5%. Conclusion: This project effectively reduced the incidence of skin injury and improved the quality of critical care. The skills related to the care and prevention of MARSI have been implemented throughout the hospital.