Efficacy of an educational program and use of soft-cloth barrier wipes

Purpose:  The purpose of this study was to determine the effect of nursing staff education and the use of soft cloth barrier wipes on the incidence of Incontinenece Associated Dermatitis (IAD) in a population of incontinent older adults.

Subjects and Setting: 54 incontinent older adults residing in a suburban nursing care center comprised a convenience sample for this study.  All the individuals had multiple co-morbidities and were wheelchair or bedbound.  Patients in the short term rehabilitation sections of the facility were excluded, as were any who refused the use of soft cloth barrier wipes.

Methods: A pre-post within-subject design was the formate for the research.  Nursing staff was educated on IAD and the use of the soft cloth barrier wipes.  Patients were assessed for skin breakdown prior to initiation of the use of the soft cloth barrier wipes and again after 3 months of use.  The Incontinence Associated Dermatitis Severity form (IADS) was utilized to indicate numerically the severity of skin breakdown. 

Results:  The incidence of IAD in the residents who made up the final sample was 44/49 or 95% of incontinent older adults having mild to severe IAD.  After completion of the 3 month data collection period only 6/49 or 12% of the sample had signs of IAD.  The median severity scores before the intervetions were significantly higher than the median scores after the interventions statisically. 

 Conclusions: The educational program on IAD combined with the use of soft cloth barrier wipes for prevention or treatment statistically decreases the incidence of IAD among older adults in a tertiary nursing care center.  We recommend IAD education for nursing staff along with the use of soft cloth barrier wipes in the care of incontinent older adults.