降低新生兒加護病房早產兒醫療黏性產品相關皮膚損傷發生率

Reducing the Incidence of Medical Adhesive-Related Skin Injuries in Premature Infants in the Neonatal Intensive Care Unit

背景：早產兒入住新生兒加護病房期間，其重要管路需使用醫療黏性產品來固定以避免管路滑脫。然而早產兒皮膚發育不成熟，容易產生醫療黏性產品相關性皮膚損傷，單位發生率高達47.4%。
目的：本專案目的在提升護理師操作醫療黏性產品方式及對早產兒醫療黏性產品相關皮膚損傷認知正確率，以及降低早產兒醫療黏性產品相關皮膚損傷發生率。
解決方案本專案製作照護指引手冊及操作醫療黏性產品步驟示意圖，提供護理師在照護過程有所依循。同時設置保護皮膚產品輔助操作，舉辦教育訓練，建立專科評核機制，提升護理師照護能力及品質。
結果：專案執行後一個月追蹤，護理師操作醫療黏性產品正確率提升至98.4%，對早產兒醫療黏性產品相關皮膚損傷認知正確率提升至93.6%，以及早產兒醫療黏性產品相關皮膚損傷發生率由47.4%降至2.9%。
結論：此專案改善臨床作業，完善標準作業流程，提升護理師照護能力及對早產兒照護品質，使早產兒獲得更完善及安全的照護。

Background & Problems: During the stay of premature infants in the neonatal intensive care unit, their important tubes must be fixed to the skin with medical adhesive products to ensure they remain securely emplaced. However, premature infants have immature skin development and are particularly prone to medical adhesive-related skin injuries (MARSI) , with related incidence rates reaching as high as 47.4% in our unit.
Purpose: The purpose of this project was to improve nurses’handling of medical adhesive products and the accuracy of their knowledge regarding MARSI in premature infants with the goal of reducing the incidence of MARSI in this patient population.
Resolutions: A care guide manual and step-by-step diagram for using medical adhesive products were produced to provide nurses with a reference during the care process. Also, skin protection products were prepositioned to facilitate their correct usage, educational training was held, and a specialist assessment mechanism was established to improve the care capabilities and care quality of nurses.
Results: One month after the project was launched, the accuracy rate in using medical adhesive products increased to 98.4%, the accuracy rate in recognizing MARSI in premature infants increased to 93.6%, and the incidence of MARSI in premature infants decreased from 47.4% to 2.9%.
Conclusion: This project effectively improved clinical operations, facilitated the completion of standard operating procedures, enhanced nursing capabilities and the quality of care provided to premature infants, and, as a result, ensured the provision to premature infants of more complete and safer care.