Implementation of New Disposable Incontinence Products to Promote Best Practice Recommendations of Adult Incontinence

INTRODUCTION: Maintaining healthy skin is a challenge for our nurses who care for a patient population experiencing illnesses that precipitate incontinence issues.  IAD, linked to the development of pressure ulcers, urinary tract infections, and fungal skin infections, has been managed with combined strategies of foley catheters, adult diapers, under-pads, and rectal bags.  Each carry their own inherent risk, not to mention self image concerns of our patients. While evaluating and treating the cause of the incontinence, management and containment becomes a priority.

OBJECTIVE:  To promote best practice recommendations for management and containment of adult incontinence.

METHOD:  The skin care team conducted a review of the literature, identifying best practice recommendations which include limiting the use of adult diapers and replacing them with absorbent disposable products to wick moisture away.  As part of a pilot project, four incontinence disposable products were selected for patient care that included an absorbent underpad, fecal shaped liner, bladder control pad, and pull up disposable underwear.  An adult medical-surgical unit was selected as the pilot unit.  Seven Registered Nurses and three nursing assistants were identified as unit based incontinence champions. The unit champions, with the CWOCN, developed an algorithm of care, providing education to all nursing staff.  The 6 week pilot was conducted on all shifts. Products were evaluated by staff for absorbency, frequency of change, comfort, and containment. Incontinence care champions met, reviewed evaluations, and provided final selection of incontinence products.

RESULT: New products performed better than current product line. Of note, throughout the evaluation period, there was no assessed evidence of incontinence-associated dermatitis skin injury or hospital-acquired pressure ulcer in the pelvic region.

RECOMMENDATION: Unit- based incontinence champions and nursing team recommended transition to the new disposable incontinence products and algorithm of care within the facility to promote best practice recommendations for incontinence containment.