背景：尿布性皮膚炎是常見的兒科疾病，其病生理機轉為新生兒真皮層比成人更薄，膠原纖維較短且密度較小，表皮細胞的附著性未充分發展，又因常包覆尿布使得皮膚接觸尿液和糞便，易使皮膚角質層受損，失去有效的屏障能力，最終造成皮膚受損導致新生兒的疼痛，也間接增加護理人員的負擔。
目的：發展以實證為基礎的新生兒尿布性皮膚炎照護指引，協助醫療專業人員對於新生兒尿布性皮膚炎護理實務的改變，實施一致的預防策略，降低尿布性皮膚炎的發生率及提高新生兒皮膚的完整性。
方法：本研究方法概括兩部分，第一部分為發展新生兒尿布性皮膚炎照護指引，於南部某醫學中心的嬰兒室暨嬰兒病房成立指引發展小組、分析現有的尿布性皮膚炎照護指引並建立優先的臨床問題、根據臨床問題進行系統性文獻回顧並評讀證據、撰寫照護指引建議草案、進行德菲法共識決策程序、指引方法學專家審查等步驟進行照護指引的發展。第二部分為照護指引適用性的評估，於指引發展的單位進行宣導，並於執行本指引一個月後，以結構式問卷調查護理師對實施此指引的可行性及困難度。
結果：本研究發展的新生兒尿布性皮膚炎照護指引，草案經由十位新生兒照護專家進行二回合的共識後，每項建議的同意度均達80%以上；此指引共提出19項建議，包括7項危險因子評估及12項預防措施。二位指引方法學專家均建議使用本指引，且整體指引品質達6分。在照護指引適用性的評估方面，22位參與指引臨床應用的護理師中超過80%以上均認為本指引可行且容易做到。
結論：發展出具有嚴謹度及良好品質的「新生兒尿布性皮膚炎實證照護指引」，而於指引的適用性評估，大部分護理人員認為指引建議內容於臨床可行且無困難執行。期望未來能夠於不同的醫院場域蒐集更多臨床護理人員的意見，使其具有更廣泛的適用性，亦可提升護理人員未來使用指引的意願；也可採用隨機對照試驗方式將指引作為介入措施，於不同的場域進行收案，以確認指引於預防新生兒尿布性皮膚炎的有效性，並同時蒐集新生兒照顧者的滿意度，以發展全國性的指引為目標。此外，逐步發展成「新生兒照顧者版本」及發展「治療」尿布性皮膚炎照護指引的部分，以完整提供臀部皮膚照護的實證證據。
關鍵字：新生兒;尿布性皮膚炎;實證照護指引

SUMMARY
This study aims to develop an evidence-based guideline for neonatal diaper dermatitis based on the development steps recommended by relevant organizations. We have evaluated the applicability by using convenience sampling in a baby nursery ward of a medical center in southern Taiwan. By applicating the guideline, we try to change nursing practice and implement a consistent preventive strategy, with the goal of reducing incidence of diaper dermatitis and improving skin integrity of neonates. After applicability evaluation, most clinical nursing staff believed that the guidelines are highly feasible and easy to implement. We have developed a rigorous and good quality guideline for the care of neonatal diaper dermatitis.
Key words: Neonate; diaper dermatitis; evidence-based clinical practice guideline

中央健康保險局、財團法人國家衛生研究院、財團法人醫院評鑑暨醫療品質策進會（2004）．臨床診療指引發展手冊．中央健康保險局。
考科藍台灣研究中心指引發展工作小組（2020）．台灣實證臨床指引發展及更新手冊．考科藍台灣研究中心。
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陳耀龍、王琪、王小琴、王建成、王洋洋、王健健、王夢書、田金徽、李慧、李秀霞、杜亮、周英鳳、姚亮、拜爭剛、韋當、孫鳳、馬彬、馬豔芳、商洪才…羅旭飛（2018）．化知識為行動：GRADE於系統性文獻回顧與臨床指引之應用．碩亞數碼科技有限公司。
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