Education Program for Long Term Care Facilities on Identifying the Differences between Incontinence Associated Dermatitis and Stage II Pressure Ulcers

The Value of Developing an Education Program for Long Term Care Facilities on the Differences between Incontinence Associated Dermatitis and Stage II Pressure Ulcers

Problem:In the long term care environment, many of the residents are incontinent resulting in skin damage. The staff can be challenged on trying to correctly identify the difference between incontinence associated dermatitis (IAD) and Stage II pressure ulcer. Incorrect documentation can lead to inappropriate interventions to manage the skin damage.

Approach: An in-service was provided by the CWOCN consultant on different etiology, presentation and management of IAD and Stage II pressure ulcers.  A post test was given with pictures to have the nurse identify correctly whether the skin lesions were IAD or pressure related.

Outcomes:  Follow- up chart audits and rounds were done with the staff twice a month to evaluate the correct classification of skin damage. Re-assessment for further education was done and provided based on the need and also for new staff. It was identified the need for education to also include identifying correctly intertriginous dermatitis and candidiasis. Future in-service would be developed and presented on these akin conditions.

Conclusion: The importance of providing education can be beneficial to not only the patient, the nurses but also the facility. In-correct classification of skin lesions can cost the long term care facility reimbursement denials, deficiencies and the risk of litigation.