Decreasing the rate of incontinence-associated dermatitis in intensive care units: A quality improvement project.

Purpose: Patients in the intensive care unit (ICU) are at a high risk of developing incontinence-associated dermatitis (IAD), the incidence and severity of which are positively related to pressure injuries, thus affecting nursing quality indicators. This quality improvement project aimed to decrease the severity and incidence of IAD, with a focus on enhancing awareness among nursing staff.

Design: This 36-month project was implemented via the Plan-Do-Study-Act (PDSA) model.

Subjects: and setting: Included staff members worked in the ICUs (central and emergency ICUs) at a Grade A tertiary hospital in Suzhou (South of Jiangsu), China.

Methods: The quality improvement project included three main procedures: (1) formulating and implementing a modified prevention and treatment nursing protocol for early structured skin care with perineum ventilation, formulating a guidance sheet for incontinence nursing care; (2) organizing training and assessments of theories and skills, including three special sections on incontinence care training (theoretical knowledge, project process, video watching), skills training for nursing staff, and an incontinence nursing workshop to engage and evaluate all staff; (3) annual analysis and discussion of nursing quality control.

Results: Following project completion, there was a decrease in the overall incidence of IAD. Moreover, ICU nurses may attach more importance/awareness to IAD.

Conclusions: This project successfully reduced the incidence of IAD among ICU patients.