The main function of skin acts as first line prevention role. Studies show that the incidence rate of Incontinence-associated dermatitis (IAD) caused by incontinence is as high as 36%. When treating IAD improperly, it is likely to cause wound infection, increase manpower of nurses in changing dressing. Therefore, it is important to provide effective and preventive care to reduce the incidence rate of IAD so as to promote good quality of care.
The purpose of this program is to lower the incidence rate of Incontinence-associated dermatitis (IAD) in our medical intensive care unit (ICU). Eighty-two percent of patients (n=255) in our ICU suffering from dermatitis were contributed to IAD in 2016. The incidence rate increased to 40.3% during March to April in 2017. Our analysis revealed possible causes including: First, the understanding in preventing, treating, and nursing IAD is only 78.9%. Second, the accuracy in clinical application to prevent IAD is only 58.2%.
Methods:
In order to lower the incidence rate of IAD, we have made a care-bundle in treating IAD by designing the assessment flow charts for incontinence associated dermatitis evaluation, and setting standard guidelines for incontinence associated dermatitis care. We've also made reminding cards, special tool boxes, creative bedside tables, and changing the wrapping methods of little diapers. We have hold some in-service education lessons, inter-professional collaborative practice, and regular internal audit. The period of this program was from June 1, 2017 to November 30, 2018, including three phases: planning, executing, and evaluating.
Results:
This program resulted as: the acknowledgment of incontinence associated dermatitis of our ICU members achieved to 95.7% and the accuracy of clinical care to prevent incontinence associated dermatitis increased to 91.5%. At the same time, the occurrence rate decreased to 18.5% and achieved our goal.
Conclusion:
In order to provide good quality of care, it is imperative that multi-disciplinary teamwork be executed including physicians, nutritionists, pharmacists, and nurses.