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SIGNIFICANCE: Hospitalized patients are at risk for IAD which increases healthcare costs. Focus groups indicated that nursing staff lacked knowledge about IAD prevention and management, yet an EBP for this topic is lacking. Research shows patients benefit from nurse use of a defined protocol.
METHODS: Surveillance for 3 days on 3 inpatient units (ICU, medical, oncology) determined the prevalence of incontinence and IAD before and after the EBP implementation. Review and evaluation of literature on incontinence and IAD resulted in graded, evidence based recommendations for IAD prevention and management that was validated by expert review. This protocol was the basis for an expert-validated computerized nursing education program. Pre and Post testing of staff on the 3 units and unobtrusive observation of IAD care in the ICU evaluated nursing knowledge and practice before and after EBP education.
RESULTS: Overall prevalence of urinary (UI), fecal (FI) and dual incontinence (DI) before and after the EBP = 39% and 20%. Nursing staff’s (mean [sd]) post test scores (12.1 [1.7]) were significantly higher than test scores before completing the computer education program (11.2 [2.3] p=.04). Cleansing time in minutes (mean[range]) significantly decreased pre (5.8 [0-35]) to post intervention (2.4 [.75-6.3] p < .001). Use of correct procedure elements for cleansing increased significantly pre to post (p <.001).
CONCLUSIONS: Findings indicated a clear need for an EBP. A computer based education program improved knowledge of IAD prevention, management and incontinence care. Nurses successfully influenced hospital purchasing decisions for skin care products. The IAD EBP and education successfully improved nursing practice.