新生儿医用粘胶相关性皮肤损伤预防及管理的最佳证据总结

doi:10.3761/j.issn.0254-1769.2022.08.018

摘要/Abstract

摘要：

目的检索并获取新生儿医用粘胶相关性皮肤损伤（medical adhesive-related skin injury,MARSI）预防及管理的相关证据,为临床实践提供依据。方法系统检索UpToDate、BMJ Best Practice、国际指南协作网、美国国立指南库、加拿大安大略注册护士协会网站、医脉通、澳大利亚乔安娜布里格斯研究所（Joanna Briggs Institute,JBI）循证卫生保健中心数据库、Cochrane Library、Embase、PubMed、Science Direct、中国知网等关于新生儿MARSI预防及管理的证据,包括指南、最佳实践信息册、临床决策、证据总结、系统评价、专家共识。检索时限为2011年1月1日—2021年2月18日。由2名研究者按照JBI循证卫生保健中心的文献质量评价标准和证据预分级及证据推荐级别系统进行文献质量评价以及证据提取。结果共纳入10篇文献,其中指南2篇、证据总结2篇、系统评价2篇、专家共识4篇。最终从皮肤评估、皮肤保护、用物选择、操作方法、管理及培训5个方面总结18条最佳证据。结论该研究总结了新生儿MARSI预防及管理的最佳证据,建议临床应用中结合科室和新生儿的实际情况,制订相应的护理措施,以科学的方法解决新生儿MARSI的问题,减少皮肤损伤的发生。

关键词: 新生儿, 医用粘胶相关性皮肤损伤, 循征护理学, 儿科护理学

Abstract:

Objective To retrieve and obtain relevant evidence on the prevention and management of medical adhesive-related skin injury（MARSI） in neonates to guide clinical practice. Methods We searched UpToDate,BMJ Best Practice,Guidelines International Network（GIN）,National Guideline Clearinghouse（NGC）,Registered Nurses Association of Ontario （RNAO）,Medlive,Joanna Briggs Institute （JBI）,Cochrane Library,Embase,PubMed,Science Direct,CNKI to collect relevant guidelines,recommended practice,evidence summaries,systematic reviews and expert consensuses published form January 1,2011 to February 18,2021. There were 2 researchers who evaluated the quality of the literature and extracted evidence according to the Australian JBI Centre for Evidence-Based Health Care’s literature evaluation criteria and evidence grading system. Results A total of 10 articles were included,including 2 guidelines,2 evidence summaries,2 systematic reviews,4 expert consensuses. A total of 18 pieces of best evidence were collected,mainly involving 5 aspects of skin assessment,skin protection,employment choices,operation methods,management and training. Conclusion This study summarized the best evidence for the prevention and management of MARSI in neonates. It suggests that the nursing administrators should take the actual situation into consideration to formulate relevant nursing measures in clinical practice. We should solve the problem of MARSI in neonates in a scientific way,which can reduce the occurrence of skin injury and improve nursing quality.

Key words: Neonates, Medical Adhesive-Related Skin Injury, Evidence-Based Nursing, Pediatric Nursing

张娟, 何娇, 罗黎, 张岚, 韩燕红. 新生儿医用粘胶相关性皮肤损伤预防及管理的最佳证据总结[J]. 中华护理杂志, 2022, 57(8): 1008-1012.

ZHANG Juan, HE Jiao, LUO Li, ZHANG Lan, HAN Yanhong. Summary of best evidence for prevention and management of medical adhesive-related skin injury in neonates[J]. Chinese Journal of Nursing, 2022, 57(8): 1008-1012.

图/表 3

表1 纳入文献的一般特征（n=10）

Table 1 Characteristics of included studies（n=10）

表2 纳入指南的质量评价结果（n=2）

Table 2 Quality evaluation of guidelines（n=2）

表3 新生儿医用粘胶相关性皮肤损伤预防及管理的最佳证据总结

Table 3 Evidence summary for prevention and management of medical adhesive-related skin injury in neonates

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