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Case Study
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KISS my buttÑkeeping incontinence simple saves my butt Angela Box-Peterson, ADN, WCC, Shelby Baptist Medical Center, Alabaster, AL Fecal incontinence, especially diarrhea, leaves the peri-rectal and surrounding skin raw and irritated. The patient is at a much greater risk for pressure ulcer development and discomfort(1). Surveys indicate nursing staff have difficulty complying with incontinence care protocols for many reasons(2). A hospital conducted a performance improvement project to find an efficient solution to help the staff preventand treat skin breakdown while improving patient skin and comfort. The hospital instituted use of a disposable washcloth with a skin protectant (3% dimethicone) for patients with fecal incontinece (especially diarrhea) who were on contact isolation. These pre-moistened disposable cloths clean, moisturize, deoderize, and treat the skin in one simple step With no messy linens to bag and transport out of the room, the nursing staff immediately adopted use of the cloths and expressed satisfaction with the product, as many have(3). Within 24-48 hours, patients' skin and comfort levels greatly improved The project demonstrated that the simple step resulted in better compliance with incontinence care standards. Patients and nursing staff expressed better satisfaction. The use of the cloths was added hospital-wide for all incontinent patients. The hospital experienced an estimated savings of $160,000 over the next year due to a decrease in the number of pressure ulcers (4). Periodic pressure ulcer prevalence and incidence studies continue to support the use of the product. Keeping incontinence care simple makes a big difference. Maklebust J, Magnan MA. Adv Wound Care. 1994:7(6):25,27Ð8,31Ð4 passim Stanton MW, Rutherford MK. Hospital nurse staffing and quality of care. Rockville, MD: Agency for Healthcare Research and Quality. Research in Action Issue 14. ARHQ Pub. No. 04Ð0029.. .Inf Control Today Online. Available at: www.infectioncontroltoday.com/hotnews/47h308371.html. Accessed July 30, 2004.. .Warshaw E, Nix D, Kula J, Markon CE. Clinical and cost effectiveness of a cleanser protectant lotion for treatment of perineal skin breakdown in low-risk patients with incontinence. Ostomy Wound Manage. 2002;48(6):44Ð51 Motta GJ, Jones LR. Clinical evaluation and nurse satisfaction using premoistened disposable washcloths for skin cleansing, moisturizing, and protection after incontinence. 1999..Healthcare Products Information Services (HPIS), Hosp Market Trend Report, 3rd Qtr 2004 Amlung SR, Miller WL, Bosley LM. Adv Skin Wound Care. 2001;14(6):297Ð301 Sage products. Available at: http://www.sageproducts.com/products.asp |
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