Evidence-based practice in the use of incontinence-associated dermatitis in ICU

Abstract

Objective To formulate standardized procedure of incontinence-associated dermatitis (IAD) in ICU and evaluate the outcomes. Methods The standardized procedure of IAD, including training program, risk assessment workflow, grading intervention process and physician -nurse communication style, was formulated based on the best evidences combined with the experience of clinical team and patients needs. Then, IAD standardized procedure was applied to the quality improvement project of ICU, and the incidence and severity degrees of IAD were evaluated. Results The total incidence of IAD was on the decline before, during and after improvement, 22.43%(96/428), 16.06%(71/442), 13.90%(51/367), the difference was statistically significant (χ2=11.06,P<0.01). The incidence of severe IAD was 2.57% (11/428), 0.45% (2/442), 0.27% (1/367) before, during and after improvement, the difference was statistically significant (χ2=11.67,P< 0.01). The incidence of fungal infection was 5.14% (22/428), 2.04% (9/442), 1.63% (6/367) before, during and after improvement, the difference was statistically significant (χ2=10.53,P <0.01). Conclusions Application of evidence-based practice with specification of IAD, can improve nursing quality and promote patient safety. Key words: Dermatitis; Fecal incontinence; Urinary incontinence; Evidence-based nursing