Clinical trial of a prevention and treatment protocol for skin breakdown in two nursing homes.
OBJECTIVE
Our objective was to assess the effectiveness of skin care protocols, including a body wash and skin protectant, on skin breakdown in 2 nursing homes.


METHODS
This was a quasi-experimental pretest/posttest design study. Setting and subjects Adult residents (n = 136) of 2 skilled nursing homes consented to participate in this study. Seventy percent were women; the sample average age of 82 years.


METHODS
A researcher-designed data recording form documented resident demographics, incidence and type of skin breakdown or pressure ulcer, presence of urinary or fecal incontinence, and assessment of the effectiveness of body wash and skin protectant.


METHODS
Baseline data on prevalence of pressure ulcers and skin protocol were collected weekly for a 3-month period followed by a week-long educational program by the researchers about skin care and the body wash and skin protectant. During the 3-month trial with the body wash and skin protectant incorporated into routine care, research assistants recorded resident data weekly and researchers again assessed prevalence and incidence of pressure ulcers and skin breakdown weekly.


RESULTS
Incorporation of a body wash and skin protectant into a skin care prevention and early intervention protocol in 2 nursing homes documented a decrease in skin breakdowns from 68 pre-intervention to 40 postintervention; the decrease in agency B was statistically significant. There was a statistically significant decrease in stage I and II pressure ulcer incidence overall (pre-intervention = 19.9%, postintervention = 8.1%). Nurses evaluated the body wash and skin protectant as effective for 98% of the time used.


CONCLUSIONS
Implementation of a protocol for skin care along with staff education, including the prophylactic use of a body wash and skin protectant, reduced the incidence of skin breakdown, including pressure ulcers and perineal dermatitis, in 2 long-term care facilities.
Hunter
Susan
S
University of North Dakota, College of Nursing, School of Medicine, Grand Forks 58202-9025, USA. susan_hunter@mail.und.nodak.edu
Anderson
Julie
J
Hanson
Darlene
D
Thompson
Patricia
P
Langemo
Diane
D
Klug
Marilyn G
MG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001494:Baths; D005242:Fecal Incontinence / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009824:Ointments / Q000008:administration & dosage; D003668:Pressure Ulcer / Q000188:drug therapy / Q000451:nursing* / Q000517:prevention & control*; D015995:Prevalence; D020011:Protective Agents / Q000008:administration & dosage*; D012866:Skilled Nursing Facilities; D017592:Skin Care / Q000451:nursing*; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000150:complications
D009824:Ointments; D020011:Protective Agents