Skincare intervention

Background:

Healthcare Workers (HCW) are at high risk for developing occupational hand dermatitis (HD) due to

frequent exposure to wet work, including irritants and allergens. Amongst HCW, nurses are particularly at

high risk of HD, with an estimated point prevalence between 12-30%. The burden of disease is high with

risk of chronicity, sick leave, unemployment and impaired quality of life. Despite evidence from literature on

the importance of skin protection and care in the prevention of HD, compliance to skincare protocols in

practice is below 30%. New strategies are obviously needed.

Methods/design:



Trial design: This is a randomized clustered controlled trial.



Objectives: To assess effects of an intervention program on skin condition in HCW, consisting of regular

feedback on the consumption of provided hand creams.



Participants: The trial includes nurses performing wet work. A total of 34 wards in the Free

university academic center (VUmc, Amsterdam) are recruited as participating sites. The wards are

randomized to an intervention vs control group and followed up to18 months.



Intervention: The experimental intervention comprised provision of hand creams in dispensers at the

wards with regular training and feedback, including reports of the electronically monitored consumption.

Both the experimental and the control group receive basic education on skin protection (as care as usual).

Every six months all participants will fill in the questionnaires regarding exposure to irritants and skin

protective behavior.



Outcomes: The primary outcome is the change in Hand Eczema Severity Index (HECSI-score) from

baseline to 12 months. The secondary outcomes are the Natural Moisturizing Factor (NMF) levels in the

stratum corneum as a biomarker of skin barrier damage and the total consumption of creams per ward.



 

Conflicts of interest: The authors have declared no conflicts of interest

The proposed skincare feedback program will reduce the clinical severity of hand dermatitis compared to the ‘care as usual’

12 months

intervention program, consisting of provision of skin care products and regular feedback on the skin condition in health care workers