摘要
目的通过前瞻性单臂观察性试验探讨应用水胶体敷料改良粘贴方法预防医护人员中防护用品相关面部压力性损伤的效果。方法按照N95口罩的边缘大小分别剪大小为2 cm×5 cm的水胶体敷料4块,应用无张力粘贴的方法分别张贴包裹边缘。将本改良粘贴方法应用于隔离病房工作的护士,持续随访2周,每日报告皮肤状况,随访2周后分析压疮发生情况。结果2周的随访中20%(4/20)受试者发生鼻部压疮等级增加事件,25%(5/20)受试者发生脸颊部压疮等级增加事件,仅有5%(1/20)的受试者出现2级压疮,无受试者出现3级及以上压疮。中性/干性皮肤者脸颊部压疮等级增加的发生率为5/11,高于油性皮肤者0(χ^2值为5.378,P=0.02)。鼻部压疮等级增加与压痕消失时间的增加呈正相关性(r值为0.615,P=0.004),压痕恢复时间需要120 min以上的受试者鼻部压疮等级增加的发生率为2/8,高于30~60 min的0,以及61~120 min的1/5,差异有统计学意义(χ^2值为4.382、6.472,P<0.05)。结论水胶体敷料改良张贴方法能有效预防因长时间佩戴N95口罩相关的压力性损伤,但应做好皮肤评估,重视对中性/干性皮肤医护人员的保湿防护,加强皮肤压迫后血运恢复产品的使用,可降低医务人员被感染的风险,本方法值得在临床推广应用。
Objective To investigate the effect of an improved hydro-colloid dressing sticking method on preventing protective equipment induced facial pressure injuries among medical staff through a prospective,single-arm trial.Methods According to the size of the edge of N95 mask,four pieces of hydro-colloid dressing with a size of 2 cm×5 cm were cut,and the edges of the mask were tension-free stuck.This improved sticking method was applied to the nurses working in the isolation ward.The follow-up was continued for two weeks,skin condition was reported daily,and the occurrence of pressure ulcers was analyzed after two weeks of follow-up.Results Twenty percent(4/20)of subjects experienced increase grades of nasal and twenty five percent(5/20)in cheek pressure ulcers during a two-week follow-up.The incidence of the increased stage of cheek pressure ulcer in normal/dry skin was higher than in oily skin.Stage 2 pressure ulcers occurred in only five percent(1/20)of subjects,and no subjects had stage 3 or higher stage pressure ulcers.The incidence of increased cheek pressure ulcer grade in patients with neutral/dry skin was(5/11),higher than 0 in patients with oily skin(χ^2 value was 5.378,P=0.02).The stage of nasal pressure ulcer was positively correlated with the disappearance time of the indentation of protective equipment(r value was 0.615,P=0.004).The rate of increase in nasal pressure sore grade was higher in subjects who required more than 120 minutes of indentation recovery time(2/8)than in subjects who required 30 to 60 minutes 1/5(χ^2 value was 4.382,P<0.05)and 60-120 minutes 1/5(χ^2 value was 6.472,P<0.05).Conclusions This improved hydro-colloid dressing sticking method can effectively prevent pressure injuries related to wearing N95 masks for a long time.However,skin evaluation of medical staff should be done properly,moisture protection for normal/dry skin should be emphasized,and skin blood flow recovery after compression should be strengthened.This method can reduce the risk of infection of medical staff,and i
作者
梁艳娉
潘雪梅
张丽君
吴晓瑛
列诗韵
林金香
Liang Yanping;Pan Xuemei;Zhang Lijun;Wu Xiaoying;Lie Shiyun;Lin Jinxiang(Department of Gastroenterology,the Third Affiliated Hospital of Sun Yat-Sen University,Guangzhou 510630,China;Department of Internal Medicine,the Third Affiliated Hospital of Sun Yat-Sen University,Guangzhou 510630,China)
出处
《中国实用护理杂志》
2020年第27期2129-2135,共7页
Chinese Journal of Practical Nursing
基金
广东省医学科研基金(A2018129)。
关键词
改良
水体胶辅料
贴法
压力性损伤
Improved
Hydro-colloid dressing
Sticking method
Pressure injury
