Authors (including presenting author) :
Lam CW(1), Li KY(1), Lui KY(1), Chan CW(1)
Affiliation :
(1)Department of Medicine & Geriatrics, United Christian Hospital
Introduction :
Frail elderly is more vulnerable to skin problems such as fragile skin, Pressure Injury (PI) and Incontinence Associated Dermatitis (IAD). In clinical settings, IAD is commonly found in patients who are double incontinent, immobile and in dependent state.
Effective skin care in geriatrics requires high level of awareness, proper documentation and comprehensive communication. Any break down of the chain would highly endanger the elderly to develop skin problems. The high volume of elderly patients and high turn-over rate in acute geriatric ward become a challenge to nurses in preventing and managing skin problems. To tackle with this situation, an enhancement program was established.
Objectives :
-To uplift skin care quality for geriatric patients
-To better manage IAD
Methodology :
Skin Care Promotion Program combines workflow enhancement of IAD management with interactive trainings to all levels of staff. The program started with data analysis of current practice gap, including communication breakdown, follow-up actions accuracy and knowledge deficit. The program adopted the “Plan Do Check Act” cycle to review and enhance current practice. Current workflow was revised to fulfil updated guidelines, standardize documentation and enable comprehensive communication in handling IAD. A newly designed communication reminder was adopted for enhancing complete communication and ensure follow-up actions by nurses. Apart from that, hands-on scenario-based trainings were organized to ward nursing staff and health care assistants in which provides fundamental knowledge of IAD staging and dressing methods. Lectures combined with computerized visual simulating sessions were also organized to allow participants to grasp real pictures of IAD. The knowledge gap was evaluated by pre-test post-test method and the program brought a change of practice to enhance IAD management.
Result & Outcome :
After launching the enhancement program, the prevalence of IAD decreased by 50% in an acute geriatric ward. All participants in this program gained an increased knowledge of IAD which evidenced by pre-test post-test. All participants expressed a satisfactory comment on this program and a positive attitude towards managing IAD.
