Prevention of incontinence-associated dermatitis among residents in long-term care facilities: a best practice implementation project
Yu-Chia Chang, Wen-Yu Hu, Yun-Chen ChangABSTRACT
Introduction:
Incontinence-associated dermatitis (IAD) is a significant health concern in long-term care facilities (LTCFs), with prevalence rates ranging from 3.4% to 50% globally. In Taiwan, factors such as prolonged diaper use, limited verbal communication among residents, and insufficient caregiver training exacerbate IAD risks. Additionally, language barriers and fragmented documentation contribute to inconsistent care delivery.
Objectives:
This project aimed to improve early identification and assessment of IAD risk factors; implement evidence-based skin protection strategies; and standardize incontinence management in a 108-bed LTCF in Taiwan.
Methods:
This project followed the JBI Evidence Implementation Framework, which is grounded in an audit and feedback approach. A baseline audit was conducted to evaluate current practices against evidence-based criteria for IAD prevention. Following the identification of barriers to compliance with recommendations, interventions were designed, including staff education on IAD assessment, standardized skin care and evaluation protocols, and enhanced documentation practices. Participants included 90 residents, 8 nurses, and 18 caregivers. Two follow-up audits evaluated improvements in compliance with best practices.
Results:
The baseline audit revealed significant gaps in IAD assessment consistency and caregiver knowledge. Post-intervention audits showed a marked improvement in adherence to risk assessments and skin care protocols. Training sessions enhanced staff competency, especially among foreign caregivers, through the use of multilingual educational materials. Notably, the intervention identified barriers related to language and training, while also creating opportunities for more consistent care delivery.
Conclusions:
Ther systematic implementation of evidence-based practices reduced IAD incidence and improved care quality. Sustainability requires ongoing audits, tailored training, and institutional policy integration. This project highlights the feasibility of standardized IAD management in resource-limited LTCFs, with particular attention to the role of caregiver training and communication across different caregiver groups.
Spanish abstract:
http://links.lww.com/IJEBH/A551