| [Objective]The Purpose of this study was to investigate the effects of complex zinc oxide soothing ointment,stoma powder combined with skin Protective film on the incidence of Incontinence-associated dermatitis(IAD),time,location,damage area and severity of the skin,and analyze its economic cost and labor cost.In order to provide a basis for optimizing skin care programs.[Methods]A total of 168 incontinent patients were randomly divided into observation group 1(n=84)and observation group 2(n=84)according to computer-generated random numbers.The two groups adopted a structured skin care program based on the management of incontinence,skin cleansing and protection.The observation group 1 applied a complex zinc oxide soothing ointment to protect the skin,while the observation group 2 applied stoma powder combined with skin protective film to protect the skin for one week.The occurrence and severity of IAD were determined according to the Incontinence-associated dermatitis Severity Instrument(IADS)by professionals with international stoma therapist qualification who did not participate in the study.The time,location,and damage area was recorded by investigator.Each time incontinence was cared for,the researchers used a stopwatch to calculate the nursing time.After the end of the intervention period,each patient used the"weighing method"to calculate the weight of the products used and thus obtain the cost.SPSS 22.0 statistical analysis was used for all data results,and all data were analyzed according to the principle of intention-to-treat.[Results]In this study,168 patients were included,6 were exfoliated,and 162 patients completed the study.(1)Effect indicators:according to the per-protocol set,the incidence of IAD in the two groups was 6.5%and 20.0%;The full analysis set showed that the incidence of IAD in the two groups was 11.5%and 22.6%,and the difference was statistically significant(P<0.05).The time of occurrence in the observation group 1 was 3 to 5 days and the median time was 4 days,while that in the observation group 2 was 2 to5 days and the median time was 3 days,and the difference was not statistically significant(P>0.05).The damage area of the observation group 1 was 13.5?129.5cm2,with a median of 18.00cm2,while that of the observation group 2 was 2?19cm2,with a median of 18.50cm2,the difference was not statistically significant(P>0.05).The severity grading of the observation group 1 was 1 case of mild,1 case of moderate and 2 cases of severe,while that of the observation group 2 was 6 cases of mild,4 cases of moderate and 3 cases of severe,the difference was not statistically significant(P>0.05).IADS scores of the two groups were(11.25±9.43)and(9.23±5.93)respectively,and the difference was not statistically significant(P>0.05).(2)Cost index:The average cost per care material per patient in observation group 1 was 27.88(26.72,30.02)yuan,which was lower than that of observation group 2(30.39,24.35,38.41).The difference was statistically significant(P<0.05);The cost-effectiveness ratio of observation group 1 is 213.09,which indicates that the rate of IAD is 213.09 yuan for every one percentage point decrease,278.57 for observation group 2,and 278.57 yuan for each percentage point of IAD incidence;the incremental cost-effective ratio is 1 85.83.,indicating that the observation group 2 is reduced by one percentage point and the observation group 1 is more than 185.83 yuan.The average direct care time of each patient in observation group 1 was(4.87±0.92)min,which was lower than that of observation group 2(6.00±1.46)min,the difference was statistically significant(P<0.05);observation group 1 The average indirect nursing time of each patient was(2.44±0.48)min,observation group 2 was(2.41±0.57)min,and the difference was not statistically significant(P>0.05).The average total nursing time of each patient in observation group 1 was(7.31±1.35)min,which was lower than that of observation group 2(8.41±2.00)min,and the difference was statistically significant(P<0.05).[Conclusions]On the basis of the structured skin care program,the application of complex zinc oxide soothing ointment can reduce the incidence of IAD.However,the two skin protection programs have similar effects in shortening the occurrence time,reducing the occurrence site and damage area,and reducing the severity.After using complex zinc oxide soothing ointment,the cost effect is better than stoma powder combined with skin protective film,and the nursing time was shorter,greatly reducing the workload of nursing staff. |
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