To Develop the Bundle Care of the Incontinence Associated Dermatitis : A Evidence- Based Framework

Background: Incontinence-associated dermatitis (IAD) is a prevalent cause of skin damage in clinical settings. IAD may cause burn heat sensation, pruritus, pain, and infection. It may prolong hospital stay and increase healthcare costs.

Objective: The aim of this study was to develop a bundle care of the incontinence associated dermatitis based on the evidence- based framework.

Method: According to the steps of developing a bundle care, 4 steps were conducted. The steps included systematic review of the literature, a draft of IAD budle care, consensus of hospital nursing staff and clinical experts, evaluation of methodology experts.

Results: The initial guideline was adopted by consensus of thirty nurses and seven clinical experts (two runs) to achieve above 80% agreement. Three methodology experts evaluated the quality of development process as a use recommendation. The IAD Bundle care consisted of 4 elements with 19 interventions, including skin assessment (five activities), skin cleanse (four activities), skin protect (six activities), and supportive interventions (four activities). The IAD bundle care was standardized and evidence- based clinical guideline.

Conclusion: The result was the development of IAD bundle care, which integrating systematic literature review and the opinions of nurse staff, clinical experts, and methodology experts. Thus, these interventions of IAD Bundle care are recommended for clinical application. Further studies will be implemented to examine the effectiveness of IAD bundle care.

Keyword: evidence- based framework, incontinence associated dermatitis, bundle care.