Impact of an evidence‐based bundle on incontinence‐associated dermatitis prevalence in hospital patients: A quasi‐experimental translational study

Author:

Barakat‐Johnson Michelle123ORCID,Stephenson John3,Lai Michelle12ORCID,Basjarahil Shifa4,Campbell Jayne5,Cunich Michelle67,Disher Gary8,Geering Samara910,Ko Natalie11,Leahy Catherine12,Leong Thomas13,McClure Eve14,O'Grady Melissa11,Walsh Joan4,White Kate12,Coyer Fiona1516

Affiliation:

1. Executive Nursing and Midwifery Services Sydney Local Health District Sydney Australia

2. Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health The University of Sydney Sydney Australia

3. School of Human and Health Sciences University of Huddersfield Huddersfield UK

4. The Sutherland Hospital, Nursing and Midwifery Services South Eastern Sydney Local Health District Sydney Australia

5. Nursing and Midwifery Services Hunter New England Local Health District Newcastle Australia

6. Charles Perkins Centre, Sydney School of Medicine (Central Clinical School), Faculty of Medicine and Health The University of Sydney Sydney Australia

7. Sydney Health Economics Collaborative Sydney Local Health District Sydney Australia

8. Strategic Reform and Planning Branch New South Wales Ministry of Health Sydney Australia

9. Nursing and Midwifery Services Research Alliance South Western Sydney Local Health District Sydney Australia

10. Ingham Institute for Applied Medical Research Sydney Australia

11. Nursing and Midwifery Services, Concord Repatriation General Hospital Sydney Local Health District Sydney Australia

12. Quality, Clinical Safety and Nursing Western New South Wales Local Health District Orange Australia

13. Nursing and Midwifery Services, Royal Prince Alfred Hospital Sydney Local Health District Sydney Australia

14. Aged and Chronic Care and Rehabilitation Services Sydney Local Health District Sydney Australia

15. School of Nursing, Midwifery and Social Work The University of Queensland Brisbane Australia

16. Institute of Skin Integrity and Infection Prevention The University of Huddersfield Huddersfield UK

Abstract

AbstractThe study aimed to evaluate the effect of an intervention on the prevalence and severity of incontinence‐associated dermatitis (IAD) in six hospitals in one state in Australia. This quasi‐experimental pre‐and post‐study, conducted in 18 wards, was part of a larger implementation science study on incontinence‐associated dermatitis. Skin and incontinence assessments were conducted on patients during February and March 2020 (pre‐intervention) and July and August 2021 (post‐intervention). The intervention comprised continence assessment and management, an education brochure for patients, family and caregivers on IAD, the Ghent Global IAD Categorisation Tool (GLOBIAD) and a skin care regime with patient skin protection measures (three‐in‐one barrier cream cloths, minimisation of bed protection layers, use of appropriate continence aid). A total of 1897 patients were assessed (pre‐intervention = 964, post‐intervention = 933). A total of 343 (35.6%) pre‐intervention patients and 351 (37.6%) post‐intervention patients had incontinence. The prevalence of hospital‐acquired IAD was 6.71% in the pre‐intervention group and 4.27% in the post‐intervention group; a reduction of 36.3% (p = 0.159) despite higher patient acuity, prevalence of double incontinence and the COVID‐19 pandemic in the post‐intervention group compared with the pre‐intervention group. Our multisite best practice IAD prevention and treatment intervention was able to reduce the prevalence and severity of hospital‐acquired IAD, suggesting enduring effectiveness of the intervention.

Publisher

Wiley

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