Prevention and treatment of incontinence-associated dermatitis: literature review.
ABSTRACT This paper is a report of a review conducted to describe the current evidence about the prevention and treatment of incontinence-associated dermatitis and to formulate recommendations for clinical practice and research.
Incontinence-associated dermatitis is a common problem in patients with incontinence. It is a daily challenge for healthcare professionals to maintain a healthy skin in patients with incontinence.
PubMed, Cochrane, Embase, the Cumulative Index to Nursing and Allied Health Literature, reference lists and conference proceedings were explored up to September 2008.
Publications were included if they reported research on the prevention and treatment of incontinence-associated dermatitis. As little consensus about terminology was found, a very sensitive filter was developed. Study design was not used as a selection criterion due to the explorative character of the review and the scarce literature.
Thirty-six publications, dealing with 25 different studies, were included. The implementation of a structured perineal skin care programme including skin cleansing and the use of a moisturizer is suggested. A skin protectant is recommended for patients considered at risk of incontinence-associated dermatitis development. Perineal skin cleansers are preferable to using water and soap. Skin care is suggested after each incontinence episode, particularly if faeces are present. The quality of methods in the included studies was low.
Incontinence-associated dermatitis can be prevented and healed with timely and appropriate skin cleansing and skin protection. Prevention and treatment should also focus on a proper use of incontinence containment materials. Further research is required to evaluate the efficacy and effectiveness of various interventions.
- [Show abstract] [Hide abstract]
ABSTRACT: The aim of this analysis was to identify the association between incontinence-associated dermatitis (IAD), its most important etiologic factors (incontinence and moisture), and pressure ulcers (PUs). A systematic review and meta-analysis were performed. We searched Medline, Embase, CINAHL, Web of Science, and the Cochrane Library for relevant papers dating through March 15, 2013. Fifty-eight studies were included. Measures of relative effect at the univariate level were meta-analyzed. In most studies (86%), a significant association between variables of interest was found, with pooled odds ratios of PUs in univariate models between 1.92 (95% CI 1.54–2.38) for urinary incontinence and 4.99 (95% CI 2.62–9.50) for double incontinence (p < .05). This evidence indicates an association between IAD, its most important etiological factors, and PUs. Methodological issues should be considered when interpreting the results of this review. © 2014 Wiley Periodicals, Inc.Research in Nursing & Health 04/2014; · 2.18 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Over the past 15 years, the model of medical and nursing care changed from being exclusively oriented to the diagnosis and treatment of acute illness, to the achievement of outcomes by preventing iatrogenic complications (Hospital Acquired Conditions). Nursing Sensitive Outcomes show as nursing is directly involved in the development and prevention of these complications. Many of these complications, including falls from the bed, use of restraints, urinary catheter associated urinary infections and intravascular catheter related sepsis, are related to basic nursing care. Ten years ago in critical care, a school of thought called get back to the basics, was started for the prevention of errors and risks associated with nursing. Most of these nursing practices involve hygiene and mobilization. On the basis of these reflections, Kathleen Vollman developed a model of nursing care in critical care area, defined Interventional Patient Hygiene (IPH). The IPH model provides a proactive plan of nursing interventions to strengthen the patients’ through the Evidence-Based Nursing Care. The components of the model include interventions of oral hygiene, mobilization, dressing changes, urinary catheter care, management of incontinence and bed bath, hand hygiene and skin antisepsis. The implementation of IPH model follows the steps of Deming cycle, and requires a deep reflection on the priorities of nursing care in ICU, as well as the effective teaching of the importance of the basic nursing to new generations of nurses.Assistenza infermieristica e ricerca: AIR 06/2014; 33(2):90-96. · 0.40 Impact Factor