Proposed Topic (Most preferred): :
HA Young Investigators Session (Projects to be presented by HA staff who had joined HA for 10 years or less)
Proposed Topic (Second preferred): :
Clinical Safety and Quality Service III (Projects aiming at quality service to patients and their carers)
Authors (including presenting author) :
Au KK(1), Cheung MW(1),Ho YC(1), Leung YY(1), Tam HY(1), Wong HL(1)
Affiliation :
(1)Intensive Care Unit, Pamela Youde Nethersole Eastern Hospital
Introduction :
ICU patients are a known vulnerable group from various studies to develop incontinence-associated dermatitis (IAD). IAD not only causes discomfort and pain to patients but also decreases patients’ ability to mobilize and increases the risks of developing higher-stage pressure injuries and infection.
Objectives :
The main objectives of the continuous quality improvement program are to 1) decrease the incidence rate of IAD among patients in the PYNEH ICU, 2) prolong the onset of IAD, and 3) improve the knowledge and practical proficiency of nursing colleagues in effectively managing IAD. By addressing these objectives, we aim to enhance patient outcomes and ensure the provision of high-quality care in the PYNEH ICU setting through the evidence-based project.
Methodology :
The quality improvement program of IAD management was conducted with prospective pre- and post-test quasi-experimental design in the mixed medical-surgical intensive care unit of Pamela Youde Nethersole Eastern Hospital from 1st February to 28th May 2023. Patients who had diarrhea during the ICU stay were recruited into the program. A total of 48 patients (control group=24, experimental group=24) aged 18 years or older were involved. The experimental group would receive structured IAD management(Figure1) provided by trained nurses. A training program was conducted for nursing staff to provide updated and evidence-based information on standardized care regarding IAD management after the data collection period from the control group. Pre- and post-self-reporting questionnaires were adopted to evaluate the effectiveness of the nursing training program on degree of knowledge improvement.
Result & Outcome :
Staff outcomes
All 69 nursing colleagues returned the pre- and post-self-reporting questionnaires. The attendance rate was 82.1%. Statistical significant improvement in nursing colleagues’ knowledge was shown in the post-test (Mean= 8.22; SD=1.27) compared with the pre-test (Mean=3.50; SD=1.49) (p<0.001).
Patient outcomes
The incidence rates of IAD pre-and post-implementation of the improvement program were 42.1% (8 patients) and 11.1% (2 patients), respectively (p= 0.038). Among patients with IAD developed after recruitment, 6 cases developed stage 2A IAD in the pre-implementation group, compared with 1 case developed stage 2A IAD in the post-implementation group. The length of IAD-free days after the implementation was significantly increased to 95 days per 100 days of ICU stay from 56 days per 100 days of ICU stay before the implementation (p<0.005).
