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Information/Education Rep
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Diaper-Free Zone: Innovative Approach by a Step-Down Unit to Reduce Nosocomial Pressure Ulcers First Author: Pat Emmons Authors: Pat Emmons, RN, MSN, CNS, CWOCN Myra Lang, RN, MS, CCRN Garrett K. Chan, RN, PhD, CNS, NP Background Information: Diapers create a moist environment placing patients at risk for developing pressure ulcers. One step-down unit at Stanford Hospital and Clinics identified diaper usage as an early intervention used by nursing staff to address urinary incontinence. To change staff behavior with urinary incontinence a three phase program was designed. Objective: To evaluate if this program could reduce the units diaper usage and simultaneously decrease the pressure ulcer prevalence rate. Program Design: Phase One: To identify staff knowledge about urinary incontinence by pre-test. An educational program was given to the staff including: types of urinary incontinence, interventions for perineal care, and identification of patients with urinary incontinence. Phase Two: To introduce a dimethicone product creating a moisture barrier with diaper usage for urinary incontinent patients. Phase Three: To continue using the dimethicone product without the diapers for urinary incontinent patients. Post-test administered upon completion of phase three to evaluate staff knowledge. Outcomes Measurements: Braden scores,weekly unit prevalence studies, and staff tests. Results: in progress. In phase one, two issues arose one being patients who previously used diapers at home were reluctant to discontinue usage, and staff needed scripting help to address the patients concerns. As a result phase two and three were delayed; therefore comparison of Braden Scores,prevalence study data for phase two and three, and staff tests is not complete, however it will be at the beginning of the year. |
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