尿路造口周围刺激性皮炎患者的循证护理实践

doi:10.3761/j.issn.0254-1769.2020.11.004

摘要/Abstract

摘要：

目的将尿路造口周围刺激性皮炎患者护理的最佳证据应用于临床,提高造口专科的护理质量。方法以知识转化模式为指导,根据利益相关者的意见,对尿路造口周围刺激性皮炎护理的最佳证据进行挑选和调整以适合实践场所,以证据为基础制订实践方案,通过教育培训、质量监督和补充资源将方案应用于临床实践,比较方案应用前后的审查指标执行率、护士和患者相关护理知识水平及患者造口周围刺激性皮炎的发生率。结果方案应用后,6项审查指标执行率从0~96.00%提高到77.03%~100%。护士尿路造口周围刺激性皮炎护理知识得分从（57.86±11.49）分提高至（69.17±11.21）分,患者尿路造口周围刺激性皮炎护理知识正确率从0~96.00%提高到72.00%~100%,差异均具有统计学意义（P<0.05）。尿路造口周围刺激性皮炎发生率由32.00%下降至12.00%（P>0.05）。结论尿路造口周围刺激性皮炎患者的循证护理实践可规范护理操作,提高护士和患者的尿路造口周围刺激性皮炎护理知识水平,减少了尿路造口周围刺激性皮炎的发生。

关键词: 膀胱肿瘤, 尿路造口, 造口周围刺激性皮炎, 循证护理学

Abstract:

Objective To apply the best evidence for the management of peristomal irritant dermatitis in patients with urostomies into practice,so as to improve the quality of ostomy nursing care. Methods Guided by the Knowledge to Action Framework（KTA）,the appropriate evidence for the management of peristomal irritant dermatitis in patients with urostomies was selected and adjusted based on opinions of stakeholders. An evidence-based nursing plan was developed and applied into the clinical practice by education and training, quality monitoring, enriching resources,et al. Implementation rates of review indicators, the knowledge of nurses and patients,and incidence of peristomal irritant dermatitis were compared before and after the application of the plan. Results After application of the evidence-based practice plan, the implementation rates of the 6 review indicators were improved from 0~96.00% to 77.03%~100%. The knowledge scores of nurses increased from 57.86±11.49 to 69.17±11.21,and the accuracy of knowledge of patients increased from 0~96.00% to 72.00%~100%（all P<0.05）. The incidence of peristomal irritant dermatitis reduced from 32.00% to 12.00%（P>0.05）. Conclusion The application of the best evidence for the management of peristomal irritant dermatitis can standardize behaviors of nurses,increase the knowledge of nurses and patients,and reduce the incidence of peristomal irritant dermatitis.

Key words: Urinary Bladder Neoplasms, Urostomy, Peristomal Irritant Dermatitis, Evidence-Based Nursing

李加敏,庞冬,路潜,丁炎明,黄燕波,车新艳,张剑锋. 尿路造口周围刺激性皮炎患者的循证护理实践[J]. 中华护理杂志, 2020, 55(11): 1624-1629.

LI Jiamin,PANG Dong,LU Qian,DING Yanming,HUANG Yanbo,CHE Xinyan,ZHANG Jianfeng. Evidence-based nursing practice of peristomal irritant dermatitis in patients with urostomies[J]. Chinese Journal of Nursing, 2020, 55(11): 1624-1629.

图/表 3

表1 证据、实践方案相关文件和审查指标的关系表

Table 1 Relationship between evidence, documents related to the practice plan and audit indicators

图1 循证实践方案应用前后审查指标执行率

Figure 1 Implementation rate of audit indicators before and after the plan application

表2 循证实践方案应用前后患者尿路造口周围刺激性皮炎护理知识正确率

Table 2 Accuracy of patients’ knowledge before and after the plan application

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