Lewis-Byers Kari, Thayer Debra
Bons Secours Retirement Community, Chester, VA, USA.
Ostomy Wound Manage. 2002 Dec;48(12):44-51.
Caring for the skin of patients with incontinence is an essential activity in long-term care. A prospective descriptive study to compare the effect of two skin care protocols on skin condition, pain, and caregiver time was conducted. Thirty-two (32) skilled nursing facility residents with incontinence participated in the 3-week study. Patients were randomly assigned to a standard care regimen (soap and water cleansing after each incontinence episode, followed by application of a moisturizing lotion) or study care protocol (no-rinse skin cleanser after each episode and application of a barrier cream with durable properties after the first incontinence episode of each shift). Number and type of incontinence episodes, skin condition, pain, and caregiver time spent were assessed. Skin integrity was maintained in the majority of control (69%) and study group (72%) patients and improvement occurred in 8% of control and 17% of the study group (NS). Study protocol procedures took less time to complete than control procedures (a savings of 79 minutes/patient/day). A positive correlation between pain intensity and level of skin impairment was observed (r = 0.88). The results of this study suggest that at this facility, use of soap, water, and a moisturizer may be less effective and more time-consuming than using a no-rinse cleanser and a durable barrier product.
护理失禁患者的皮肤是长期护理中的一项重要工作。开展了一项前瞻性描述性研究，以比较两种皮肤护理方案对皮肤状况、疼痛及护理人员护理时间的影响。32名患有失禁的专业护理机构居民参与了这项为期3周的研究。患者被随机分配至标准护理方案组（每次失禁发作后用肥皂和水清洁，随后涂抹保湿乳液）或研究护理方案组（每次失禁发作后使用免冲洗皮肤清洁剂，且每班首次失禁发作后涂抹具有持久特性的隔离霜）。评估失禁发作的次数和类型、皮肤状况、疼痛情况以及护理人员花费的时间。大多数对照组（69%）和研究组（72%）患者的皮肤完整性得以维持，对照组8%、研究组17%的患者皮肤状况有所改善（无显著性差异）。研究方案的操作完成时间比对照方案短（每位患者每天节省79分钟）。观察到疼痛强度与皮肤损伤程度呈正相关（r = 0.88）。该研究结果表明，在该机构，使用肥皂、水和保湿剂可能不如使用免冲洗清洁剂和持久隔离产品有效，且更耗时。
