降低新生兒中重度病房鼻胃管壓力性損傷之發生率

Reducing the Incidence of Nasogastric Tube Pressure Ulcer in Neonatal Intermediate Care Unit

皮膚壓力性損傷將造成病嬰疼痛、哭鬧不安、增加感染率及延長住院天數的風險，本單位因使用鼻胃管造成之壓力性損傷發生率高達97.2%，經現況分析及歸納問題為：人員未依規範執行鼻胃管照護、鼻胃管受壓部位缺乏保護措施、缺乏預防鼻胃管壓力性損傷之專科照護課程及作業規範不夠完整，故執行解決辦法：一、建立定期稽核制度，二、單位增設人工皮，三、設計減壓鼻貼及減壓鼻貼操作影片，四、擬定新生兒中重度病房鼻胃管照護細則，五、規劃預防鼻胃管壓力性損傷照護教育訓練。本專案結果為鼻胃管壓力性損傷發生率能由97.2%下降至9%。說明護理人員依照護細則，善用「減壓鼻貼」及實施稽核制度，可降低病嬰鼻胃管壓力性損傷的發生，提升病嬰皮膚完整性。

Pressure-related skin injuries can cause significant discomfort and distress in infants, increase the risk of infection, and prolong hospitalization. In our unit, the incidence of pressure-related nasogastric tube injuries was as high as 97.2%. After analyzing the current situation, we identified several key issues: non-adherence to nasogastric tube care guidelines, inadequate protective measures for pressure-prone areas, the absence of specialized educational programs for preventing pressure-related injuries, and incomplete operational protocols. To address these problems, the following interventions were implemented: 1. Establishment of a regular audit system; 2. Introduction of artificial skin products in the unit; 3. Design of pressure-relieving nasal pads and development of instructional videos on their use; 4. Development of standardized nasogastric tube care guidelines for the neonatal intensive care unit; and 5. Implementation of educational training programs focused on preventing pressure-related nasogastric tube injuries. Following these interventions, the incidence of pressure-related nasogastric tube injuries decreased significantly from 97.2% to 9%. These results demonstrate that adherence to standardized care guidelines, combined with the use of pressure-relieving nasal pads and routine audits, can effectively reduce pressure-related nasogastric tube injuries and improve skin integrity in infants.