Reducing incontinence associated skin damage with incontinece pad use

The purpose of our QI project is to determine if there is a difference in the incidence of incontinence associated dermatitis and pressure ulcers in hospitalized adult incontinent patients when using the disposable absorbent underpads when compared to a similar population who are provided with the reusable incontinence underpads.

Recently the medical center trialed two types of disposable incontinence underpads in an effort to reduce costs associated with linen use. The two underpads performed equally well, however there was an increase in cost associated with their use.  Upon review to the quarterly pressure ulcer prevalence and incidence data, a reduction in the incidence of pressure ulcers and Incontinence associated dermatitis (IAD) was noted on the units that utilized the disposable underpads.

we are expanding on this data and looking at the incidence of incontinence associated dermatitis and pressure ulcers in the incontinent adult patient on four medical surgical units.  We have supplied the disposable absorbent under pads to two of the units.  The remaining two units will receive the current standard which is the reusable absorbent underpads.  All patient units receive education on the use of absorbent incontinence pads and prevention of incontinence dermatitis, so that each unit has same baseline information.  

Current practice at MMC includes use of absorptive product such as reusable (laundered) incontinence pads as part of a comprehensive skin care bundle. The MMC skin care bundle includes cleansing with pH balanced no-rinse cleanser, followed by application of moisturizer.  For patient’s that are incontinent, a barrier ointment is applied as well.

Conclusion: Hospitalized adult patients with urinary or fecal incontinence demonstrate a lower incidence of incontinence – associated dermatitis (IAD) and pressure ulcer development when managed with disposable incontinence underpads when compared to patients managed with re-usable incontinence pads.