ICU患者医用粘胶相关性皮肤损伤预防最佳证据的临床转化  

Clinical translation of the best evidence for prevention of medical adhesive-related skin injury in ICU patients

作　　者：顾梦倩 顾丽华 黄怡丹 刘颖[3,4] 朱丽群 邱丽华[1] Gu Mengqian;Gu Lihua;Huang Yidan;Liu Ying;Zhu Liqun;Qiu Lihua(Department of Critical Care Medicine,Changshu NO.1 People′s Hospital,Changshu 215500,China)

机构地区：[1]常熟市第一人民医院(苏州大学附属常熟医院)重症医学科,江苏常熟215500 [2]常熟市第一人民医院(苏州大学附属常熟医院)护理部,江苏常熟215500 [3]南方医科大学南方医院血液科 [4]南方医院JBI循证护理合作中心 [5]江苏大学附属医院护理部

出　　处：《护理学杂志》2025年第5期57-63,共7页Journal of Nursing Science

基　　金：常熟市科技计划社会发展项目(CS202219);常熟市护理学会科研项目(CSHL-A-202402);国家卫健委医院管理研究所2024医疗质量(循证)管理研究项目(YLZLXZ24G078)。

摘　　要：目的探讨成人ICU患者医用粘胶相关性皮肤损伤预防证据在临床转化的效果,为开展相关研究提供依据。方法将394例患者按住院时间分为基线审查组、第1轮证据应用组、第2轮证据应用组、第3轮证据应用组,每组94例。以CLARITY循环为指导,将筛选出的29条成人ICU患者医用粘胶相关性皮肤损伤预防最佳证据进行3轮临床应用。结果审查指标总体达标率由11.11%提升至81.48%;ICU护士医用粘胶相关性皮肤损伤预防知识总分由55.0(43.8,60.0)提升至90(78.8.95.0);ICU患者医用粘胶相关性皮肤损伤发生率由20.21%降为3.19%;ICU治疗费用和医用粘胶剂相关费用差异无统计学意义(均P>0.05);患者家属满意度差异有统计学意义(P<0.05)。系统层面新增医用粘胶剂使用和揭除流程,并持续检测应用效果。结论开展成人ICU患者医用粘胶相关性皮肤损伤预防与管理的循证实践,可提升ICU护士对各项审查指标的执行率和预防知识的掌握程度,降低医用粘胶相关性皮肤损伤的发生率,提高患者家属满意度,促进最佳证据向临床实践科学转化。Objective To explore the effect of clinical translation of Medical Adhesive-related Skin Injury(MARSI)prevention evidence in adult ICU patients,and to provide a basis for conducting related research.Methods A total of 394 patients were divided into a baseline review group,a round 1 evidence application group,a round 2 evidence application group,and a round 3 evidence application group according to their hospitalization time,with 94 cases in each group.Using the CLARITY cycle as a guide,the 29 screened best evidence for MARSI prevention in adult ICU patients were applied in 3 rounds of clinical application.Results The overall compliance rate of the review metrics increased from 11.11%to 81.48%;the total knowledge score of ICU nurses on MARSI prevention increased from 55.0(43.8,60.0)to 90(78.8,95.0);the incidence of MARSI in ICU patients decreased from 20.21%to 3.19%;and the difference between ICU treatment costs and medical adhesive-related costs were not statistically signi-ficant(all P>0.05);the difference in patient family satisfaction was statistically significant(P<0.05).At the system level,the process of using and removing medical adhesive was added,and the application effect were continuously tested.Conclusion Carrying out the evidence-based practice of prevention and management of MARSI in adult ICU patients can improve the implementation rate of various review indicators and the mastery of prevention knowledge among ICU nurses,reduce the incidence of MARSI,improve the satisfaction of patients′families,and promote the scientific transformation of the best evidence to clinical practice.

关 键 词：重症监护病房 危重症患者 医用粘胶剂 皮肤损伤 预防 CLARITY循环 证据转化 循证护理 

分 类 号：R471[医药卫生—护理学]