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Park and Choi: Adaptation and Evaluation of the Incontinence Care Protocol
Original Article

Journal of Korean Academy of Nursing 2015; 45(3): 357-366.

Published online: 30 June 2015

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

Adaptation and Evaluation of the Incontinence Care Protocol

Kyung Hee Park1, Heejung Choi2

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 27 October 2014       Revised 24 November 2014       Accepted 23 March 2015

© 2015 Korean Society of Nursing Science

(open-access):

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.

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

Figures and Tables

Table 1

Focused Health Questions for Incontinence Care Protocol

jkan-45-357-i001
Table 2

Final Version of Incontinence Care Protocol

jkan-45-357-i002
Table 3

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

jkan-45-357-i003

*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)

jkan-45-357-i004

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

Table 5

Difference in Total Score of BWAT (N=40)

jkan-45-357-i005

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

Notes

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

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