A descriptive exploratory survey of incontinence-associated dermatitis in the intensive care setting: The ADDrESS study

Background: Incontinence-associated dermatitis (IAD)develops from skin exposure to urine, faeces or both. Previous studies have tested different IAD management practices in critically ill patients in the intensive care unit (ICU); however, actual clinical practices reported for IAD prevention and management remain unknown. This study aimed to understand Australian registered nurses’ current clinical practices to prevent and manage IAD in the ICU. Method: This study used a cross-sectional exploratory survey design. Members of the Australian College of Critical Care Nurses (ACCCN) Ltd were invited to complete an electronic survey. Results: Response rates were 5.6% (111/1967) of the total email invitations sent or 10.6% (111/1051) of those who read the invitation. Most participants were female (88.3%, n=98), with 69.4% (n=67) working in a metropolitan hospital, and 91% working in a public hospital. Participant recall of IAD frequency was 10.4%. Various methods were identified to prevent and manage IAD, including skin protection at the patients’ general bed-bath and at episodes of incontinence clean-up. The lack of IAD management policy in ICUs was common across the participant group. Conclusion: Clinical practices to prevent and manage IAD were found to be the same. Formal IAD management protocols in ICUs were limited in number. Keywords: Critically ill patients, incontinence-associated dermatitis, intensive care, survey