Abstract:

Objective To retrieve,evaluate and integrate the relevant evidence of prevention of medical adhesive-related skin injury in elderly patients at home and abroad,and to summarize the best evidence. Methods We systematically searched for evidence on prevention of medical adhesive-related skin injury in BMJ,UpToDate,JBI,RNAO,SIGN,CGC,Cochrane Library,PubMed,EMbase,INS,ISTAP,CBM,Wanfang,CNKI,Taiwan academic literature database of China,including guidelines,systematic reviews,best practices information sheet,evidence summary,expert consensus and original research. The retrieval period was from the inception of databases to May,2019. Results A total of 11 articles were included,including 3 guidelines,1 evidence summary,3 expert consensus,3 randomized controlled trials and 1 cohort study. Six aspects were summarized：skin evaluation,skin protection,operational readiness,manipulation,observation and maintenance,supervision and training. Twenty items of best evidence were included. Conclusion Nurses should standardize the methods of medical adhesives sticking and removing,accurately identify high-risk groups,and take skin protection measures. In the application of evidence,the best evidence should be selected according to the clinical situation,so as to reduce the incidence of skin injury related to medical adhesives and improve the quality of nursing.

Key words: Aged, Medical Adhesive, Skin Injury, Prevention, Evidence-Based Nursing

摘要：

目的 检索、评价并整合国内外关于老年患者医用胶粘剂相关性皮肤损伤预防的相关证据,并对最佳证据进行总结。方法 系统检索British Medical Journal最佳临床实践、UpToDate、Joanna Briggs Institute（JBI）循证卫生保健中心数据库、加拿大安大略注册护士协会网、苏格兰学院间指南网、中国指南网、Cochrane Library、PubMed、荷兰医学文献数据库、美国输液护理学会网站、国际皮肤撕裂伤专家咨询组网站、中国生物医学文献数据库、万方数据库、中国知网数据库、中国台湾学术文献数据库中所有关于预防医用胶粘剂相关性皮肤损伤的证据,包括指南、专家共识、最佳实践、系统评价、证据总结及原始研究,检索时限为建库至2019年5月。由2名研究者独立完成纳入文献的质量评价,并结合专业人士的判断,对符合质量标准的文献进行证据提取及总结。结果 共纳入11篇文献,其中3篇指南,1篇证据总结,3项专家共识,3项随机对照试验,1篇队列研究。总结的最佳证据涵盖皮肤评估、皮肤保护、操作准备、操作手法、观察及维护、监管及培训6个方面,共20条证据。结论 护理人员应规范医用胶粘剂粘贴及移除的手法,并准确识别高危人群,采取皮肤保护措施。证据应用过程中应结合临床情境,选择有针对性的最佳证据,以降低老年患者医用胶粘剂相关性皮肤损伤的发生率,提升护理质量。

关键词: 老年人, 医用胶粘剂, 皮肤损伤, 预防, 循证护理学