Disposable Versus Reusable Absorbent Underpads for Prevention of Hospital-Acquired Incontinence-Associated Dermatitis and Pressure Injuries.

Abstract

PURPOSE:

The primary purpose of our study was to determine if there is a difference in the occurrence of hospital-acquired pressure injuries (HAPIs) and incontinence-associated dermatitis (IAD) in incontinent adults using a disposable versus reusable absorptive underpads. We also compared hospital length of stay in the 2 groups.

DESIGN:

Randomized controlled trial using cluster randomization based on inpatient care unit.

SUBJECTS AND SETTING:

Four hundred sixty-two patients admitted to 4 medical-surgical study units participated in the study; 252 used reusable underpads (control group) and 210 subjects used disposable underpads (intervention group). The study setting was a 711-bed acute care hospital located in Brooklyn, New York.

METHODS:

Two units were randomly allocated to use disposable incontinence pads, and the remaining 2 units used standard, reusable incontinence pads. Data for PI and IAD occurrences were collected weekly by specially trained RNs (skin care champions) on the assigned units. A 2-level hierarchical linear model was used to analyze the effects of the intervention on primary and secondary outcomes separately from any effects of the unit of randomization.

RESULTS:

HAPIs were significantly lower in the disposable underpads group: 5% versus 12% (P = .02). Rates of hospital IAD were not significantly different between the groups (P = .22). Analysis of a secondary outcome, hospital length of stay, was also lower in patients who used disposable underpads (6 days vs 8 days; P = .02).

CONCLUSIONS:

Findings suggest that use of disposable incontinence pads reduces HAPI but not IAD occurrences. The effect of disposable, absorbent incontinence pads should be considered when initiating a hospital-wide skin and PI prevention and treatment plan.

• Authors: Kathleen Francis, Sau Man Pang, Brenda Cohen, Helene Salter, Peter Homel
• Journal: Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society (J Wound Ostomy Continence Nurs) 2017 Jul/Aug Vol. 44 Issue 4 Pg. 374-379 ISSN: 1528-3976 [Electronic] United States
• PMID: 28549048 (Publication Type: Journal Article, Randomized Controlled Trial)

Topics

• Absorbent Pads (standards, statistics & numerical data)
• Aged
• Aged, 80 and over
• Dermatitis (etiology, prevention & control)
• Female
• Humans
• Iatrogenic Disease (prevention & control)
• Incontinence Pads (standards, statistics & numerical data)
• Male
• Middle Aged
• New York City
• Pressure Ulcer (etiology, prevention & control)
• Statistics, Nonparametric
• Urinary Incontinence (complications)