CASE STUDY:
How four Belgian hospitals address the challenges of incontinence care in geriatric wards

The 4 hospitals

The Jan Yperman Hospital, AZ Jan Palfijn Ghent, O.L.V. van Lourdes Hospital Waregem and the Sint Jozefskliniek transformed their approach to incontinence care – moving beyond traditional methods to test a faster, more effective “washing without water” solution.

Jan Yperman Hospital

  • Beds: 532
  • Employees: 1,300
  • Admissions: 16,217
  • Day admissions: 26,215

AZ Jan Palfijn Ghent

  • Beds: 519
  • Employees: 1,100
  • Admissions: 13,299
  • Day admissions: 16,352

O.L.V. van Lourdes Hospital Waregem

  • Beds: 266
  • Employees: 768
  • Admissions: 11,436
  • Day admissions: 16,268

Sint Jozefskliniek

  • Beds: 270
  • Employees: 625
  • Admissions: 24,000

Managing Incontinence-Associated Dermatitis (IAD):

exploring two different care approaches

Incontinence care is a constant priority in geriatric wards, often bringing significant challenges for both patients and care-givers. Patients with incontinence are highly susceptible to IAD, a painful skin condition caused by prolonged exposure to urine and faeces. In fact, IAD prevalence in Belgian hospitals has been reported to range from 5% to 50%.

Despite the heavy burden on nursing staff, IAD is not sufficiently explored or analysed during nursing education, as Ian Hollevoet, nurse and Regional Sales and Project Manager at Deforce Medical, notes: 

“The topic of IAD is not sufficiently explored or analysed during nursing education.”

The challenge

Traditional incontinence care – based on water, soap, and barrier creams – is not only physically straining but often ineffective at preventing IAD. Nurses face time constraints,lack of specialized training, and a shortage of preventive protocols, leading to missed opportunities in early intervention.

At the same time, hospitals lack critical data about IAD prevalence, mainly due to:

Difficulty differentiating between IAD and pressure ulcers

Protocols focus more on treatment than prevention

Nurses' limited time and energy for implementing new methods

Two different approaches to managing IAD

1. Traditional incontinence care
  • Involves cleaning with water and soap
  • Application of separate barrier creams
  • Often inconsistent and time-consuming
  • Higher rates of IAD development and slower  healing of existing cases
2. Washing without water
  • Cleaning, caring for, and protecting the skin in  one single step with the use of wet gloves or wipes
  • Made it easier for nurses to follow and standardize care protocols
Arion foto 1 1

The methodology

Effective management of IAD requires additional care and investment in preventive measures. Recognizing this, the four participating hospitals sought a deeper understanding of the prevalence of IAD and its impact on nursing workload.

Supported by Ian Hollevoet, the hospitals conducted a comparative study of two different incontinence care approaches. Through systematic data collection, they gained a clear and objective view of the extent of the problem. The differences between the methods were significant.

Study results

Using Swash® instead of traditional washing methods:

· Lower IAD incidence by 43 percentage points
· Higher IAD resolution by 25 percentage points
· Nurses were able to prevent IAD more effectively and improve patient comfort

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