Decreasing Incontinence-Associated Dermatitis in the Surgical Intensive Care Unit: A Quality Improvement Project.

Area of Science:

• Quality Improvement in Healthcare
• Nursing Practice
• Dermatology

Background:

• Hospital-acquired incontinence-associated dermatitis (IAD) is a common complication in patients with fecal and urinary incontinence.
• Effective skin care protocols are crucial for preventing IAD and improving patient outcomes.

Purpose of the Study:

• To evaluate the effectiveness of a skin care algorithm in reducing hospital-acquired IAD rates.
• To assess the impact of evidence-based bundled interventions on IAD prevention in an intensive care setting.

Main Methods:

• A quality improvement project was conducted in a surgical intensive care unit (SICU).
• An algorithm with bundled skin care interventions was implemented after staff education.
• Data on IAD rates, algorithm compliance, and documentation accuracy were collected pre- and post-intervention.

Main Results:

• A 24% reduction in hospital-acquired IAD was observed after algorithm implementation (29% vs 5%).
• The average time to onset of hospital-acquired IAD increased from 15 to 25 days.
• High algorithm compliance and accurate IAD documentation were noted.

Conclusions:

• The implemented skin care algorithm effectively reduced hospital-acquired IAD.
• Bedside nurses, even without specialized skin expertise, can successfully identify and manage IAD.
• This QI project highlights the potential for standardized protocols to improve patient skin integrity.