Efficacy of a comprehensive strategy to reduce moisture-associated skin damage in an intensive care unit: A quasi-experimental study.

OBJECTIVES

Assess the impact of a bundle of interventions to reduce the incidence of moisture-associated skin damage in an intensive care unit.

METHODS

Quasi-experimental study with pre-post comparison carried out in a general intensive care unit. The intervention consisted of an online training on skin lesions and implementation of a skin care program. In the pre-post intervention period, the skin of the pelvic area was assessed daily until the appearance of a moisture-related lesion or intensive care unit discharge. Demographic and clinical variables, type of moisture lesion and severity were collected. To assess the impact of the intervention the odds ratio (OR) adjusted for the confounding variables was used.

RESULTS

Trained nurses accounted for 87.7%. In each phase 145 patients were studied. The incidence of moisture-associated skin damage in the pre-phase was of 29% and 14.5% in the post phase. The OR adjusted for the confounding variables (ICU length of stay, obesity, faecal incontinence and non-communicative patients) was 0.44 (95%CI:0.23-0.82). The reduction of incontinence-associated dermatitis presented an OR of 0.81 (95%CI:0.30-2.16) and intertriginous dermatitis of 0.39 (95%CI:0.17-0.85).

CONCLUSIONS

Online training for nurses and the introduction of structured skin care reduced by half the moisture-associated skin damage, especially intertriginous dermatitis.