Nursing practice and quality improvement in the implementation of group standards for incontinence-associated dermatitis
失禁性皮炎团标执行中的护理实践与质量改进

摘要

目的 探讨失禁性皮炎（Incontinence-Associated Dermatitis, IAD）相关团体标准（简称“团标”）在临床护理中的执行路径与质量改进策略。方法 以某三级医院呼吸科、重症医学科、神经内科等IAD高发科室为对象，构建“培训—执行—监测—改进”闭环管理体系，通过分层培训、标准化护理实践及PDCA循环持续改进，对比分析团标执行前后护理质量及患者结局。结果 团标执行6个月后，护理人员团标知晓率由72.1%升至96.5%，风险评估及时率、预防措施落实率分别由81.4%、76.8%升至97.7%、95.3%；IAD总发生率由14.7%降至4.2%，中重度IAD发生率由3.8%降至0.9%，护理满意度由85.6分升至93.5分（P＜0.05）。结论 建立科学的团标执行与质量改进机制，可显著提升IAD护理标准化水平与防控效果，降低并发症风险，优化患者体验，具有较强的推广价值。

Abstract

Objective To explore the implementation pathways and quality improvement strategies of group standards (referred to as “group standards”) related to Incontinence-Associated Dermatitis (IAD) in clinical nursing practice.
Methods Focused on high-incidence IAD departments such as the Respiratory Department, Intensive Care Unit, and Neurology Department of a tertiary hospital, a closed-loop management system of “training—implementation—monitoring—improvement” was established. Through hierarchical training, standardized nursing practices, and continuous improvement via the PDCA cycle, nursing quality and patient outcomes before and after the implementation of the group standards were comparatively analyzed.
Results Six months after implementing the group standards, the awareness rate of the standards among nursing staff increased from 72.1% to 96.5%. The timely completion rate of risk assessments and the implementation rate of preventive measures rose from 81.4% and 76.8% to 97.7% and 95.3%, respectively. The overall incidence of IAD decreased from 14.7% to 4.2%, and the incidence of moderate to severe IAD decreased from 3.8% to 0.9%. Nursing satisfaction scores increased from 85.6 to 93.5 (P<0.05).
Conclusion   Establishing a scientific mechanism for implementing group standards and quality improvement can significantly enhance the standardization of IAD nursing care and prevention effectiveness, reduce complication risks, optimize the patient experience, and has strong promotion value.