Kyung Hee Park; Heejung Choi

doi:10.4040/jkan.2015.45.3.357

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Original Article
Adaptation and Evaluation of the Incontinence Care Protocol: Kyung Hee Park, Heejung Choi; Journal of Korean Academy of Nursing 2015;45(3):357-366.
DOI: https://doi.org/10.4040/jkan.2015.45.3.357
Published online: June 30, 2015

¹Department of Nursing, Samsung Medical Center, Seoul, Korea.

²Department of Nursing, Konkuk University, Chungju, Korea.

Address reprint requests to: Choi, Heejung. Department of Nursing, Konkuk University, 268 Chungwon-daero, Chungju 380-701, Korea. Tel: +82-43-840-3954, Fax: +82-43-840-3929, hjchoi98@kku.ac.kr

• Received: October 27, 2014 • Revised: November 24, 2014 • Accepted: March 23, 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0/) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

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Abstract
NOTES
REFERENCES

Abstract

Purpose
This study was done to develop an evidence-based incontinence care protocol through an adaptation process and to evaluate the effects of the protocol.
Methods
The protocol was developed according to the guideline of adaptation. A non-randomized controlled trial was used for testing the effects of the new Incontinence Care Protocol. A total of 120 patients having bowel incontinence with Bristol stool type 5, 6, and 7 and admitted to intensive care units were recruited to this study. The newly developed incontinence care protocol was used with patients in the experimental group and conventional skin care was given to patients in the control group. Outcome variables were incontinence-associated dermatitis (IAD) severity, pressure ulcer occurrence and severity.
Results
The experimental group had significantly less severe IAD (t=6.69, p<.001), lower occurrence of pressure ulcers (χ²=7.35, p=.007), and less severity of pressure ulcers (Mann-Whitney=86.00, p=.009) than the control group.
Conclusion
Use of this incontinence care protocol has the effects of preventing pressure ulcers and inhibiting worsening of IAD and pressure ulcers. Therefore, this incontinence care protocol is expected to contribute to managing IAD and pressure ulcers.
Keywords: Dermatitis; Fecal incontinence; Pressure ulcer; Practice guideline; Evidence-based nursing

This manuscript is a condensed form of the first author's doctoral dissertation from Konkuk University.

REFERENCES

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Table 1

Focused Health Questions for Incontinence Care Protocol

Table 2

Final Version of Incontinence Care Protocol

Table 3

Homogeneity Test on General Characteristics and Dependent Variables (N=120)

^*Fisher's exact test; ^†Bristol Stool Scale; ^‡Septic, hypovolemic, cardiogenic shock; ^§Pre-albumin<20 (mg/dL), albumin<2.5 (g/dL) or NPO longer than 3 days;

Exp.=Experimental group; Cont.=Control group; ICU=Intensive care unit; BMI=Body mass index.

Table 4

Difference in IADS Scores and Pressure Ulcer Occurrence (N=120)

Exp.=Experimental group; Cont.=Control group; IADS=Incontinence-associated dermatitis and its severity.

Table 5

Difference in Total Score of BWAT (N=40)

Exp.=Experimental group; Cont.=Control group; BWAT=Bates-Jensen wound assessment tool; MR=Mean rank; SR=Sum of ranks.

Figure & Data

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Adaptation and Evaluation of the Incontinence Care Protocol

J Korean Acad Nurs. 2015;45(3):357-366. Published online June 30, 2015

DOI: https://doi.org/10.4040/jkan.2015.45.3.357

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Adaptation and Evaluation of the Incontinence Care Protocol

Table 1

Focused Health Questions for Incontinence Care Protocol

Table 2

Final Version of Incontinence Care Protocol

Table 3

Homogeneity Test on General Characteristics and Dependent Variables (N=120)

^*Fisher's exact test; ^†Bristol Stool Scale; ^‡Septic, hypovolemic, cardiogenic shock; ^§Pre-albumin<20 (mg/dL), albumin<2.5 (g/dL) or NPO longer than 3 days;

Exp.=Experimental group; Cont.=Control group; ICU=Intensive care unit; BMI=Body mass index.

Table 4

Difference in IADS Scores and Pressure Ulcer Occurrence (N=120)

Exp.=Experimental group; Cont.=Control group; IADS=Incontinence-associated dermatitis and its severity.

Table 5

Difference in Total Score of BWAT (N=40)

Exp.=Experimental group; Cont.=Control group; BWAT=Bates-Jensen wound assessment tool; MR=Mean rank; SR=Sum of ranks.

Table 1 Focused Health Questions for Incontinence Care Protocol

Table 2 Final Version of Incontinence Care Protocol

Table 3 Homogeneity Test on General Characteristics and Dependent Variables (N=120)

^*Fisher's exact test; ^†Bristol Stool Scale; ^‡Septic, hypovolemic, cardiogenic shock; ^§Pre-albumin<20 (mg/dL), albumin<2.5 (g/dL) or NPO longer than 3 days;

Exp.=Experimental group; Cont.=Control group; ICU=Intensive care unit; BMI=Body mass index.

Table 4 Difference in IADS Scores and Pressure Ulcer Occurrence (N=120)

Exp.=Experimental group; Cont.=Control group; IADS=Incontinence-associated dermatitis and its severity.

Table 5 Difference in Total Score of BWAT (N=40)

Exp.=Experimental group; Cont.=Control group; BWAT=Bates-Jensen wound assessment tool; MR=Mean rank; SR=Sum of ranks.