Reducing Hospital-Acquired Pressure Ulcers and Incontinent Associated Dermatitis by Implementing a Skincare Program in Critical Care

Pressure Ulcers (PUs) represent a serious problem for patients within the hospital care setting and is a significant care management challenge. Incontinence Associated Dermatitis (IAD) also presents as a challenge as IAD is often mistaken for Stage I and Stage II PUs. The 2012 Consensus on IAD states that PUs and IAD are distinct clinical entities that require different treatment modalities. While there is an extensive body of knowledge regarding pressure ulcer prevention (PUP) protocols, IAD prevention protocols remain under consideration. 

Purpose:  Our study sought to implement and evaluate the effect of clinical education and new skin care products on reducing HAPU and IAD rates.

Method:  This study was conducted utilizing the Incontinent Associated Dermatitis Severity Instrument (IADS) and Pressure Ulcer Prevalence Surveys to obtain IAD and HAPU rates. A pretest was administered to all RNs and Patient Care Associates (PCAs) to establish their level of knowledge related to skin care and pressure ulcer prevention. Following clinical education on skin care and PUP a post test was administered. A new skin care product regimen was implemented with the ICU staff. The data was compared before and after the evaluation to determine the outcomes regarding the effectiveness of the program.  

Findings:  During the study, both the HAPU and IAD rates decreased by approximately 50 %. The test scores increased by 37 % for the RNs and 24 % for the PCAs.

Discussion/Conclusion:  Our objective was to decrease the HAPU and IAD rates. The implementation of this new skin care program combined with clinical education proved to be beneficial. Further study is needed as we expand our use hospital wide.