新型冠状病毒防护装备所致医护人员皮肤损伤的预防处理现况及对策
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女,硕士,主任护师,护士长

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上海王正国创伤医学发展基金会课题(WZGF20200101);全军卫勤专项课题(20WQ027)


Investigation of prevention and management of skin injuries associated with the use of personal protective equipment among medical staff fighting against COVID-19
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    摘要:

    目的 探讨新型冠状病毒防护装备所致医护人员皮肤损伤的预防处理现况及对策。方法 采用自行设计的问卷对新型冠状病毒肺炎疫情防控一线的医护人员以问卷星形式进行网络在线调查,分析其皮肤损伤发生类型及特点、预防处理措施的实施情况。结果 共调查医护人员2 901人,其中1 069人(2 794处)发生皮肤损伤,皮肤损伤发生率为36.8%(95%CI 35.1%~38.6%),压力性损伤发生率26.6%(95%CI 25.0%~28.2%),潮湿相关性皮肤损伤发生率8.8%(95%CI 7.8%~9.8%),皮肤撕裂伤1.5%(95%CI 1.0%~1.9%)。穿戴一、二、三级防护装备者皮肤损伤发生率分别为9.5%、43.1%和85.8%,差异有统计学意义(P<0.01)。采取预防措施者仅占13.1%(380人),其中使用泡沫敷料、水胶体敷料和涂抹油剂分别占3.7%(107人)、5.8%(169人)和5.9%(170人)。皮肤损伤发生后,57.0%使用了不同方法处理。结论 防护装备引起的皮肤损伤高发于穿戴二、三级防护装备的医护人员,以压力性损伤为主,潮湿相关性皮肤损伤其次,预防和处理措施不足且不规范。建议从组织层面和个人层面加强管理,有效干预,维护一线医护人员的皮肤健康。

    Abstract:

    Objective To investigate and analyze prevention and management of skin injuries associated with the use of personal protective equipment among medical staff fighting against COVID-19,and to provide references for countermeasures. Methods A self-designed questionnaire was launched in Wenjuanxing website and accessed by front-line medical staff fighting against COVID-19. The occurrence of skin injuries associated with the use of personal protective equipment, the characteristics of the injuries, prevention and management measures were analyzed. Results A total of 2 901 medical staffers completed the questionnaire survey, and 1 069 staffers developed 2 794 lesions of skin injuries. The incidence rate for skin injuries, pressure injuries, moisture-associated skin damage and skin tear stood at 36.8%(95%CI 35.1%-38.6%),26.6%(95%CI 25.0%-28.2%),8.8%(95%CI 7.8%-9.8%),1.5%(95%CI 1.0%-1.9%) respectively. The incidence rate of skin injuries caused by wearing level 1,level 2 and level 3 personal protective equipment was 9.5%, 43.1% and 85.8%,respectively, with the difference being statistically significant (P<0.01). Only 380 staffers (13.1%) took preventive measures for skin injuries: 3.7%(107/2 901) used foam dressing, 5.8% (169/2 901) used hydro-colloid dressing, and 5.9% (170/2 901) used oiling agents. In 1 069 cases with skin injuries, 57.0% used different methods to manage the injuries. Conclusion The incidence rate of skin injuries, which were predominantly pressure injuries, followed by moisture-associated skin damage, in medical staff wearing level 2 and 3 protective equipment was high. The prevention and management measures they used were insufficient and non-standard. It is suggested to ramp up management from organizational and individual levels, and take effectively measures to keep the skin healthy for front-line medical staff fighting against COVID-19.

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蒋琪霞,徐娟,魏巍,江智霞,张艳红,王静,唐永利,刘海英,华皎,韩秋英,陈爱华,白育瑄,薛嘉宇,朱冬梅.新型冠状病毒防护装备所致医护人员皮肤损伤的预防处理现况及对策[J].护理学杂志,2020,35(8):4-7

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  • 收稿日期:2020-03-02
  • 最后修改日期:2020-03-20
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  • 在线发布日期: 2022-08-31