15EMOLLIENT THERAPY IN OLDER HOSPITAL IN-PATIENTS WITH DRY SKIN

Abstract

Topic: The skin is an effective barrier against infection, but an organ frequently overlooked by clinicians. Dry skin (xerosis) is a common condition in older adults which functions poorly as a barrier, causing discomfort, pruritus and consequently excoriations and skin breaks (potential entry points for infection). Therefore, the aims of this audit were to improve the quality of skin care received by elderly in-patients and to improve awareness of the importance of skin as an organ amongst healthcare professionals. Intervention(s): Standards for emollient therapy for dry skin were created using SIGN 2011 guidance on the 'Management of Atopic Eczema in Primary Care' and the Ipswich Hospital 'Management of Pressure Ulcers Guidance' as there are no existing national guidelines. Data for a closed loop audit were collected prospectively and included 76 patients (39M; 37F), aged 58-99 in the audit and re-audit. Patients were examined for evidence of xerosis. Medical notes, nursing notes and drug charts were used to ascertain information regarding co-morbidities and emollient use. Departmental education was instigated and posters were distributed to educate and remind staff members. Improvement: 12% of patients had an emollient prescribed in the initial audit, improving to 66.7% when re-audited. 23.1% of patients with both dry skin and current infection had an emollient prescribed in the initial audit; this improved to 83.3%. 50% of patients with both diabetes and dry skin had a moisturiser prescribed when re-audited as compared to 0% in the initial audit. Discussion(s): This audit includes a simple intervention which would allow nationwide implementation of the emollient use recommendations. Regular prescribing of emollients for dry skin will improve patient comfort and should reduce the risk of developing infections such as cellulitis. Areas for further research include measuring the impact of improved skincare and infection rates in the clinical setting.