Abstract:

Objective To explore the evidence based effects of continuous quality improvement of incontinence- associated dermatitis（IAD） in adult ICU. Methods Based on the theoretical framework of evidence-based quality continuous improvement model,the relevant evidence of prevention and management of IAD in adult ICU was found through systematic literature search and quality evaluation. Nine quality improvement measures were proposed. From December 1,2018 to February 1,2019,29 incontinent patients and 46 ICU nurses were examined at baseline by means of observing,checking nursing records,analyzing literature,and questionnaire survey. The obstacles in evidence application were collected and analyzed. Problem solutions were proposed including introducing IAD risk assessment tools,standardizing incontinence assessment and processing records,formulating IAD prevention and control measures,and improving IAD related knowledge system training. From February 10,2019 to July 30,2019,the evidence was introduced and nurses used these evidence measures to care for 51 incontinence patients. The use of evidence measures was investigated among the nurses. Nurses’ IAD related knowledge,the implementation rate of related nursing behaviors and the change of IAD incidence before and after the evidence application were all evaluated. Results The IAD related knowledge and the implementation rate of nursing behavior were significantly increased after the evidence measures were implemented（P＜0.05）. The incidence of IAD was reduced from 24.1% to 5.9%. Conclusion The continuous quality improvement of incontinence-associated dermatitis in adult ICU based on evidence can help to reduce the incidence of IAD in incontinence patients,make nurses have rules to follow and improve the quality of nursing.

Key words: Intensive Care Units, Fecal Incontinence, Urinary Incontinence, Dermatitis, Nursing Care, Evidence-Based Practice