4554 MOISTURE MATTERS: Controlling moisture related to incontinence reduces pressure ulcer incidence

Jeannie Thompson, BSN, RN, CWOCN, DAPWCA , Senior Select Home Health, Certified Wound Ostomy Continence Nurse, McKinney, TX
Maria Thomas, RN, MSN , Dallas VA Medical Center, Critical Care Staff Development Specialist, Dallas, TX
Rebecca Scribner, BSN, RN, CWON , Dallas VA Medical Center, Certified Wound Ostomy Nurse, Dallas, TX
Matthew Newton, BSN, RN, CCRN , Dallas VA Medical Center, CCU Nurse, Dallas, TX
Dawn Angel, BSN, RN, CWS, DAPWCA , Encompass Home Health, Certified Wound Specialist, Duncanville, TX
MOISTURE MATTERS:  Controlling moisture related to incontinence reduces pressure ulcer incidence.

Objective: To reduce the incidence of hospital-acquired pressure ulcers related to moisture from urine or stool; reduce the number of incontinent pads and linens used under patients; reduce the amount of laundry costs; augment the effectiveness of rental alternating air mattress overlays; increase patient comfort; and improve patient and staff satisfaction. 

Design: Observational, interventional, and product evaluation questionnaire.  Each incontinence pad will be studied for thirty days and eleven desirable features will be compared between the presently used super absorbent air-permeable pad and three comparable super absorbent air-permeable pads.  Data will be collected on hospital-acquired pressure ulcers during each month of the trial.

Setting: Medical Intensive Care Unit (MICU) and Coronary Care Unit (CCU)
Main Outcome Measure:  Reduction of hospital-acquired pressure ulcers. Determination of the incontinence pad with the highest desirable features ratings.
Main Results: The incidence of hospital-acquired pressure ulcers decreased from five per month to one per month.  One super absorbent air-permeable incontinent pad surpassed all trialed incontinent pads on every feature.
Conclusions:  The implementation of this quality improvement (QI) project provides several advantages. Using the national pressure ulcer treatment cost and hospital-acquired pressure ulcer data from a large tertiary hospital, this QI project demonstrates the potential cost savings of $5,875,720.00 per year in pressure ulcer treatment costs.  Implementation and success of the new incontinent pad usage will be dependent on staff education, follow-through and accountability.