Abstract:

Objective To develop the management information system of recognition,prevention and control of incontinence-associated dermatitis（IAD） and to explore its application effects in the prevention and nursing management of clinical incontinence dermatitis. Methods The management group of IAD was established,and the management information system of IAD identification and prevention and control was constructed. The man-machine interaction technology was used to develop four modules,including evaluation,grading,decision-making and nursing documents,so as to realize the functions of evaluation and early warning,intelligent interpretation of grading judgment, decision-making guidance and record preservation. It was officially put into clinical application in July 2019. The time-consuming,timely rate,accuracy rate,update rate and incidence rate of IAD were compared before and after the application of the system. Results After the application of the information system,the time to implement risk assessment of patients by nurses was shortened from（2.88±0.38） min to（1.44±0.45） min;the timely rate of risk assessment of IAD increased from 52.5% to 82.5%;the accuracy rate of assessment increased from 57.5% to 85.0%,and the update rate of risk assessment of IAD increased from 17.5% to 77.5%（P<0.05）. The incidence of IAD decreased from 16.0% to 11.8%（P>0.05）. Conclusion The management information system of recognition,prevention and control of IAD can provide accurate and objective decision-making bases for nurses,shorten the time for risk assessment of incontinence-associated dermatitis,improve the timely rate and accuracy of assessment,the dynamic updating rate of risk assessment and grading assessment,and help to improve the quality of skin care for incontinence-associated dermatitis.

Key words: Clinical Decision Support System, Hospital Information Systems, Incontinence-Associated Dermatitis, Quality Management, Nursing Care

摘要：

目的 开发失禁性皮炎识别与防控管理信息系统,探讨其在危重症患者失禁性皮炎预防和护理管理中的应用效果。方法 成立失禁性皮炎管理小组,构建失禁性皮炎识别与防控管理信息系统,采用人机交互技术,包括评估、分级、决策、护理文书4个内容模块,从而实现评估预警、分级判定、指导决策和保存记录等功能。2019年7月正式在临床应用,比较系统应用前后护士评估危重症患者失禁性皮炎风险的用时、及时率及准确率、风险评估及分级评估的动态更新率、失禁性皮炎发生率等指标。 结果 应用失禁性皮炎识别与防控管理信息系统后,护士评估危重症患者失禁性皮炎风险的用时由（2.88±0.35） min缩短至（1.44±0.22） min,评估及时率由52.5%上升至82.5%,评估准确率由57.5%提高至85.0%,失禁性皮炎风险评估的动态更新率由17.5%上升至77.5%,分级评估的动态更新率由20.0%提高到77.8%,差异均有统计学意义（P<0.05）。失禁性皮炎发生率由16.0%降至11.8%（P>0.05）。 结论 失禁性皮炎识别与防控管理信息系统能为护士提供准确、客观的决策依据,能缩短失禁性皮炎风险评估用时,提高评估及时率、准确率、风险评估及分级评估的动态更新率,有助于提高失禁性皮炎皮肤护理质量。

关键词: 临床决策支持, 护理信息系统, 失禁性皮炎, 质量管理, 护理