Authors (including presenting author) :
Mak HN (1), Shit KYF(1), Tong SY(1), Lam MY(1), Cheung KWA(1), Yu HY(1), Leung YY(1), Wong YK(1), Lee LN (1), Sze YMS (2), Lam SWT (2)
Affiliation :
(1)NTEC Wound Services Team, Department of Surgery, Prince of Wales Hospital, (2) NTEC Wound Management & Pressure Injury Prevention Workgroup
Keyword 1: :
Incontinence-associated dermatitis
Keyword 2: :
Pressure injuries
Keyword 3: :
Skin care protocol
Keyword 4: :
Assisted turning
Introduction :
Incontinence-associated dermatitis (IAD) can predispose to Pressure injuries (PI), which are both common complications among hospitalized patients due to incontinence and poor skin integrity. This study “Structured Turning-assisted Skin Care Regime for IAD/PI Prevention in NTEC”, by early identification and targeted skin care interventions, aimed to prevent and promote healing of these skin complications.
Objectives :
To implement a structured skin care regime for IAD and PI prevention.
To promote healing of IAD and PI by early identification and intervention.
To facilitate skin care routine by introduction of assisted turning device.
Methodology :
The study was conducted from May 5 to June 8, 2025, involving multiple departments in AHNH, BBH, CHS, NDH, PWH, SH, and TPH in NTEC. Using convenience sampling, both existing and newly admitted inpatients, with a Norton Score < 10 and Incontinent Score of 1, were considered eligible if they had no IAD or PI at recruitment. 5 sets of skin care products—Linovera Oil, Hydraguard Silicone Cream, and Protectant Z Guard Paste plus 4 assisted turning devices were distributed to each participating ward. Ward staff implemented interventions according to training containing skin care instructions (special double creams application method) with product application techniques and turning device usage guides. Daily patient skin assessment was recorded in a Patient Summary. CMS Clinical photographs of key areas (sacral, trochanter, ischium, perineal) were taken upon exit or when IAD/PI occurred. Additionally, staff could give feedbacks on the intervention's effectiveness using evaluation questionnaires.
Result & Outcome :
Totally 61 patients were recruited, mean age = 76.5 (33-101). Median of study duration was 5 days. 23 patients (38%) completed a study period of 14 days. 25/38 patients exited the study due to discharge (66%), 9/38 transfer out (24%) and 4/38 death (10%). Mean Norton Score on recruitment was 8.7. Only 5 cases (8.2%) suffered from IAD, which occurred on Day 3–9, with one case presented erythema and 4 cases have skin loss. Overall, only 1 patient (1.6%) developed stage 1 sacral PI. Assisted turning device was applied in 33 patients (54%) with Norton score ≤7. Positive feedbacks were received from staff. Low incidence rates confirm effectiveness of all the structured prevention bundle (IAD 8.2%; PI 1.6%). Prompt and intensive skin assessment and management can greatly promote healing of IAD.
