The role of interventional patient hygiene in improving clinical and economic outcomes.

OBJECTIVE: To successfully educate, integrate, and empower nonlicensed personnel in the surgical intensive care unit in the use of a skin care protocol to maintain and improve skin integrity. DESIGN: Observational intervention study. SETTING: Surgical intensive care unit. PATIENTS: Data related to alterations in skin integrity were collected over 4 months, representing approximately 2000 patient-days. A total of 97 specific events representing 121 "areas of concern" were identified by nonlicensed personnel. INTERVENTIONS: Nonlicensed staff members' knowledge in 6 key areas related to pressure ulcer (PrU) development was surveyed before and after implementation of an interventional patient hygiene (IPH) program incorporating comprehensive bathing and incontinence protocols. A unique point-of-use skin inspection tool was used by nonlicensed personnel to communicate areas of concern to licensed personnel (registered nurses [RNs]). MAIN OUTCOME MEASURES: Reduction in PrUs and improvement in nonlicensed staff knowledge of facility protocols. MAIN RESULTS: Incidence of new PrUs decreased from 7.14% at baseline to 0% at the end of the study. Nonlicensed staff knowledge increased to 100% in all 6 knowledge areas. CONCLUSION: Implementation of an IPH program incorporating comprehensive bathing and incontinence management resulted in enhanced communication between nonlicensed staff and RNs as well as improved patient outcomes.