Authors (including presenting author) :
SIU KY(1), YIU SM(1), KAUR S(1)
Affiliation :
(1) DEPARTMENT OF MEDICAL AND REHABILITATION, TUNG WAH EASTERN HOSPITAL, HONG KONG EAST CLUSTER
Introduction :
Incontinence-associated dermatitis (IAD) is a significant health challenge worldwide (Wounds International, 2017), particularly affecting weak and fragile older adults, long-term geriatric care or rehabilitation facilities, due to urinary and/or fecal incontinence. The estimated prevalence rate of IAD ranges from 5.6% to 50%, while incidence rates vary from 3.4% to 25% (Wound International, 2017). IAD may cause significant physical and psychological distress in elderly patients, often resulting in extended hospital stays that can escalate healthcare costs. Tung Wah Eastern Hospital (TWEH) is a medical rehabilitation hospital in which most of our patients are fragile and frail elderly, and usually with incontinence problems. Despite there is no formal statistics of IAD prevalence in TWEH, early identification and prevention of IAD are crucial. To address the observed knowledge and practice gap among Patient Care Assistants (PCAs) regarding IAD management, an “IAD Awareness Education Program” has been launched.
Objectives :
1. To enhance the PCAs’ awareness and knowledge about IAD.
2. To foster a culture of Early Identification, Early notification, Early Prevention and Early Management in IAD care.
3. To promulgate the 3 core steps of IAD management.
4. To promote collaboration between nurses and PCAs to improve IAD care quality.
Methodology :
21 Patient Care Assistants (PCAs) from Department of Medicine and Rehabilitation, TWEH participated in the education program. Participants' clinical experience included 57.1% with 0-2 years, 14.4% with 3-5 years, and 28.5% with over 5 years. A pre-test using Goggle form assessed participants' knowledge of IAD and continence care. A 15-minute video PowerPoint mini-lecture with demonstration video was prepared and distributed to all participants via a QR code link. The program was conducted from June to December 2024, covering the pathophysiology of IAD, risk factor, prevention methods, the significance of early detection and notification, the rationale of nurse-guided IAD management, including a video demonstration of the 3-core steps of IAD management technique. A mandatory post-test evaluated participants' understanding, with course evaluations collected concurrently. All educational materials were provided in Chinese to accommodate the participants' backgrounds. Post-test results were shared with participants upon completion.
Result & Outcome :
All PCAs (100%) completed the pre-test, post-test and evaluation surveys. A paired sample T-Test revealed a statistically significant improvement in IAD knowledge (p = 0.004) when comparing pre-test and post-test scores. The most notable improvements were observed in understanding IAD risk factors (44%), treatment direction (58%) and application of incontinence care products (30%). After the course, 86% of the participants reported increased confidence in identifying and managing IAD, as indicated by higher mean Likert scale responses in the post-test survey.
