Development of a Need-based Interventional Skin Care Protocol on Incontinence-associated Dermatitis among Critically Ill Patients

Abstract

A bstract Background Incontinence-associated dermatitis (IAD) is a potentially serious skin injury that can lead to pressure ulcers (PUs). Many studies have indicated the need for evidence to find the most effective skin care protocol to reduce the incidence and severity of IAD in critically ill patients. Aim and objective To develop a need-based interventional skin care protocol on IAD after identifying the risk of developing IAD in critically ill patients and by assessing the nurse's knowledge and practice on IAD. Materials and methods Quantitative research approach with an exploratory research design was adopted in the study. A total of 40 staff nurses and 100 patients were included. To assess the knowledge of staff nurses regarding IAD, a knowledge questionnaire was administered and the IAD prevention practice among staff nurses was assessed with the help of an observation checklist. The risk of IAD among 100 critically ill patients was observed by the investigator, using a perineal risk assessment tool. The obtained data were analyzed by using descriptive and inferential statistics. The protocol was developed by the researcher and it was validated by 5 experts. Results The results revealed that most of patients (60%) had a high risk for development of IAD. Most of the nurses had poor knowledge (40%) and had poor practice in assessment, perineal area, and prevention of infection area. Hence considering all these aspects, a protocol was developed. Conclusion The researchers developed a need-based skin care protocol to decrease the development of IAD. How to cite this article Sharma P, Latha S, Sharma RK. Development of a Need-based Interventional Skin Care Protocol on Incontinence-associated Dermatitis among Critically Ill Patients. Indian J Crit Care Med 2021;25(2):158–165.

Incontinence-Associated Dermatitis

“…Nurses' knowledge, attitudes, and practices of IAD alone cannot be expected to explain the prevalence of IAD. Many factors affect the development of IAD, such as the critical condition of the patient, skin characteristics, incontinence, mobility, infections, clinical setting, nutrition, and hospital conditions (eg, equipment, materials, number of staff) 8,15,18,30,40. Most nurses did not receive training on IAD and there are no formal IAD care protocols in the hospital; this suggests that nurses develop knowledge and attitudes about IAD as they gain clinical experience.…”

“…21 There are several studies showing the effects of training programs, evidence-based practices, and protocols provided to nurses in reducing IAD. [25][26][27][28][29][30] As such, literature reveals the importance of nurses in preventing and managing IAD. There is no research in the literature evaluating the relationship between nurses' knowledge, attitudes, and practices of IAD, with the prevalence of IAD.…”

“…Although nurses' knowledge and attitude toward evidence-based practices enable them to decide and apply the correct clinical practices related to IAD,23,24 nurses' knowledge gaps, negative attitudes, and inappropriate practices seriously affect the integration of evidence into practice 21. There are several studies showing the effects of training programs, evidence-based practices, and protocols provided to nurses in reducing IAD 25–30. As such, literature reveals the importance of nurses in preventing and managing IAD.…”