Implementation of Disposable Incontinence Pads to Increase Safe Skin Practices

Background

At a community based acute-care facility, quilted pads were still being utilized for incontinence management.  The hospital has an older population and serves many long-term care facilities. Quilted pads were thought to be cost-effective and well-liked by the staff. The challenge was to educate and change practice while being cost effective, in addition to, reducing our high incidence of moisture associated skin damage.

Purpose

Decrease the incidence of moisture associated skin breakdown by

-   Replacing reusable quilted pads with breathable incontinence pads

-   Being cost neutral or cost effective

-   Reducing the use of incontinence adult briefs

-   Reducing layers of linen

-   Educating nurses to improve practice

Methods

An analysis was done to determine the financial cost of breathable briefs while improving patient outcomes.  Guidelines were then implemented based on this analysis.

Education of the guidelines included disposable pads, acceptable practice of utilizing briefs, linen changes and defined nursing responsibilities. Staff accountability was obtained.

Breathable pads replaced all quilted pads. One fitted sheet was placed on each bed with a disposable incontinence pad if guidelines were met.   Diaper supply was dramatically reduced and controlled with a log to monitor usage. 

Monthly audits of layers of linen as well as skin inspection were completed to monitor staff adaption of new guidelines as well as determine effectiveness of new disposable pads.    

Results

Utilizing one layer of linens increased from 10.1% to 44.5% as the brief usage decreased from 15.6% to 5.7%. Moisture management improved from 65% to 84%. In addition to being cost effective, staff satisfaction increased. Implementation of disposable incontinence pads led to a dramatic decrease in moisture associated skin damage with an increase in safe skin practices.