Abstract: Reducing the Incidence of Incontinence Associated Dermatitis in Intensive Care Unit Diarrhea Patients (50th Annual Conference)

Chia Chi Liu¹, Tsai-Rung Lin², Miin-Rong Hwang², Hui-Hsien Nien², Pei-Shan Shie² and Sue-Huei Chen², (1)Kaohsiung Medical University Hostipal, Kaohsiung Medical University, Kaohsiung, Taiwan, (2)Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan

Background & Problems: Incontinence associated dermatitis (IAD) is a common skin disorder in critical patients who suffer from fecal incontinence. Symptoms of IAD include pain, redness, swelling, and, in some cases, secondary infections. IAD is thus a major problem faced in critical nursing care. The incidence of incontinence associated dermatitis averaged 34.72% at the intensive care unit in our hospital from October to December 2013. The factors that we identified as associated with IAD included: (1) Nurses: incorrect nursing care and insufficient IAD-related knowledge among nurses; (2) Devices: lack of skin barrier products and the use of diapers with poor air ventilation; (3) Regulations: lack of IAD care standards and lack of auditing oversight; (4) Patient problems: skin edema, incontinence, and medication use.

Purpose: To decrease the incidence of IAD from 34.72% to 22%.

Methods: The authors searched the Cochrane, PubMed, CINAHI, and Nursing Reference Center databases for relevant articles that were published from 2000 to 2014. Fifty studies were identified and four evidence-based references were selected for follow-up assessment. Levels of evidence were at levels 2 and 3. We designed an intervention that: (1) set a high-risk notice to increase awareness; (2) held six in-service training programs; (3) developed nursing standards
and designed e-learning education lessons that specifically targeted reducing the incidence of IAD; (4) established a regular audit system.

Result: The incidence of IAD decreased from 34.72% pretest to 19.8% posttest (posttest period: April - October 2014).Maintenance phase the incidence of IAD is 19.3% from January -July 2015.

Conclusion: This project effectively reduced the incidence of IAD in high-risk patients in our intensive care unit. The authors established evidence-based interventions that significantly improved patient outcomes.

Keywords: diarrhea, incontinence associated dermatitis, skin care

R03 Reducing the Incidence of Incontinence Associated Dermatitis in Intensive Care Unit Diarrhea Patients