Skin care protocols for pressure ulcers and incontinence in long-term care: a quasi-experimental study.

Abstract

OBJECTIVE:

To evaluate the effect on pressure ulcer prevalence, incidence, and healing time of incorporating use of a specific body wash and a skin protectant into skin care protocols that are based on guidelines from the Agency for Health Care Policy and Research.

DESIGN:

Quasi-experimental intervention study.

SETTING:

2 rural long-term-care facilities.

PARTICIPANTS:

A convenience sample of 136 residents at 2 rural long-term-care facilities during a 3-month preintervention and a 3-month postintervention period.

INTERVENTIONS:

A 3-month preintervention observation period (baseline) was followed by a staff in-service session, in which the use of a body wash and a skin protectant was introduced into skin care protocols, and a 3-month postintervention observation period. The skin care protocols included skin assessment techniques, prevention and treatment strategies for Stage I and Stage II pressure ulcers, and management of incontinence.

MAIN OUTCOME MEASURES:

Differences in the occurrence and healing time of Stage I and Stage II pressure ulcers before and after introduction of use of a body wash and a skin protectant into skin care protocols and the occurrence rate of urinary and fecal incontinence.

RESULTS:

Stage I and Stage II pressure ulcers significantly decreased from 35 preintervention to 14 postintervention (t = 19.48, df = 47, P = .05). The prevalence of pressure ulcers preintervention was 11.3%, compared with 4.8% postintervention (t = 2.47, df = 1.0, P = .24), The change in the incidence of pressure ulcers was significant (t = 8.48, df = -2.0, P = .01), with 32.7% preintervention and 8.9% postintervention. Healing time for pressure ulcers ranged from 4 to 70 days preintervention (mean [M] = 22.72 +/- 18.25) to 6 to 49 days postintervention (M = 16.0 +/- 12.93). The decrease in pressure ulcer healing time (rapid, medium, and long) preintervention to postintervention was statistically significant (chi 2= 14.9, P = .001). The presence of fecal and urinary incontinence was significantly associated with the development of Stage I and Stage II pressure ulcers (chi2= 44.8, P = .000).

CONCLUSIONS:

Implementation of skin care protocols that included use of a body wash and a skin protectant reduced the incidence of Stage I and Stage II pressure ulcers and decreased healing time. The skin protectant and body wash used in the protocols were found to be effective in preventing and treating Stage I and Stage II pressure ulcers.

• Authors: Patricia Thompson, Diane Langemo, Julie Anderson, Darlene Hanson, Susan Hunter
• Journal: Advances in skin & wound care (Adv Skin Wound Care) Vol. 18 Issue 8 Pg. 422-9 (Oct 2005) ISSN: 1527-7941 [Print] United States
• PMID: 16217154 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Fecal Incontinence (therapy)
• Humans
• Long-Term Care (standards)
• Practice Guidelines as Topic
• Pressure Ulcer (therapy)
• Rural Health
• Skin Care (standards)
• Urinary Incontinence (therapy)