| [Objective]To construct a reliable and effective tool for investigating the status of Incontinence-associated dermatitis;To obtain the epidemiological characteristics and nursing status of incontinence and Incontinence-associated dermatitis in adult inpatients in 18 tertiary hospitals in Jiangsu province and to analyze the risk factors of the occurence of incontinence-associated dermatitis in incontinence patients;To provide the basis for the prevention and management for incontinence-associated dermatitis.[Method]On the basis of literature review,through the brainstorming and group discussion,we established the primary version of research tool on Incontiennce-associated dermatitis.And the final version was developed by three rounds of Delphi expert consultation.Two tertiary hospitals in Jiangsu Province were recruited to analyze the reliability and feasibility of the research tool.Though recruiting,checking,signing a joint research protocol,we selected 18 tertiary hospitals in Jiangsu province as units of multicenter study.A total of 1013 nurses as data collectors who received training and passed examination.Identify an unified research day and research processe and method.The tool was used to examine the inpatients’ skin with hospital stay ≥24h and age ≥18 years.All the data were analyzed by SPSS20.0.[Result]Results of research tool construction:①The Incontinence-associated dermatitis research tool includes four primary indicators:general information,disease information,skin observation data,prevention and treatment information.And another 20 secondary indicators;②Three rounds of Delphi experts positive coefficient are all 100%(questionnaire recovery rate).Authoritative coefficient is 0.88.Expert opinion Kendall coordination coefficient of three rounds of consultation were 0.123(P=0.000)、0.176(P=0.000)、0.235(P=0.000).The first round of expert consultation,coefficient of variation varied from 0.00 to 0.23,the second round was 0.00～0.17,the third round was 0.00～0.24;The content validity index is 0.99;③Results of a pilot survey in two tertiary hospitals showed that the Cronbach’s alpha coefficient of the IAD investigative tool was 0.83,with the Cronbach’s alpha coefficient of the Braden scale was 0.80;The feasibility analysis of the tool showed that the utility and convenience rates were 99.87%and 99.67%,respectively.The completion of per questionnaire was(5.21 ± 2.23)min.Results of the multi-centre cross-sectional survey:①The mean scores of the 1013 nurses was(92.57 ± 5.00)points,with the qualified rate was 97.24%.There was no significant difference in the scores of nurses from different ages,age,title and educational background(P<0.05).②Of the 20084 hospitalized patients,the prevalence of incontinence was 3.71%(745/20084),the prevalence of urinary incontinence was 1.65%,the fecal incontinence was 0.37%and the urinary incontinence was 1.99%.The prevalence of Incontinence-associated dermatitis in hospitalized patients was 0.49%(99/20084),and the prevalence of Incontinence-associated dermatitis in incontinence was 13.29%(99/745);Incontinence-associated dermatitis in the distribution of various departments showed that the highest prevalence of Incontinence-associated dermatitis is in the emergency,36.36%;③The most common site of Incontinence-associated dermatitis is perianal,accounting for 48.90%,while the most common grade is mild,accounting for 68.61%;Among the Incontinence-associated dermatitis patients,the prevalence of pressure ulcer is 13.13%;Prevention and management measures for Incontinence-associated dermatitis include the use of absorbent pads and diapers,accounting for 66.67%,topical use of skin protection agent,accounting for 65.66%,the use of drainage tube,accounting for 56.57%and the use of skin cleaning solution,accounting for 29.29%.Only 6.06%of Incontinence-associated dermatitis patients did not take any measures;④The univariate analysis of Incontinence-associated dermatitis in incontinent patients showed that the occurrence of Incontinence-associated dermatitis was related to gender,hospitalization time,perception ability,humidity,incontinence type and incontinence duration.Logistic regression indicated that gender,perception,Fecal incontinence,incontinence duration were independent risk factors for Incontinence-associated dermatitis.(P<0.05)[Conclusion]①The research tool of Incontinence-associated dermatitis has good reliability and validity,which is suitable for clinical application.②The results of multi-center investigation showed that incontinence is a common nursing problem in hospitalized patients,and Incontinence-associated dermatitis is a common skin injury in incontinent patients;Clinical nurses have a higher rate of prevention and management measures for Incontinence-associated dermatitis;Female,perceived defect,high humidity and fecal incontinence are risk factors for incontinent patients developing Incontinence-associated dermatitis. |
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