Incontinence-Associated Dermatitis in a Long-term Acute Care Facility

Long, Mary Arnold; Reed, L; Dunning, Kari; Ying, Jun

doi:10.1097/won.0b013e3182486fd7

Cited by 78 publications

(75 citation statements)

References 9 publications

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“…The time to onset of IAD in this study of community-living adults performing their usual skin care routines was approximately 14 days, which was similar to residents in long-term care on a skin damage prevention program, 2,6 but considerably longer than the duration in critically-ill patients who received usual care and had an average onset of 4 days. 7 These differences may be due in part to differences in illness severity, frequency or severity of fecal incontinence, skin care routines, and level of independence in perineal hygiene among the various patient groups.…”

Section: Discussionsupporting

confidence: 56%

“…IAD manifests as redness, breakdown, fungal infection/rash. 1 The skin damage of IAD can occur in various areas of the perineum such as between the buttocks, on the outer buttocks, and thighs, and in the groin area 2 and can cause discomfort and pain for patients. 3 Understanding the epidemiology and characteristics IAD in various clinical settings provides important information about its scope and assists in planning resources needed for prevention and treatment interventions.…”

Section: Introductionmentioning

confidence: 99%

“…In hospitalized patients, the prevalence of IAD was 20% 4 while in critically-ill patients, it was as much as 50%. 5 In long-term acute care (LTAC), the incidence of IAD was 7.6% 2 while in nursing home residents on a skin damage prevention program the incidence was 3.4%. 6 In both LTAC 2 and nursing homes 6 , the time to onset of IAD was approximately two weeks while in critically-ill patients onset was only 4 days.…”

Section: Introductionmentioning

confidence: 99%

“…5 In long-term acute care (LTAC), the incidence of IAD was 7.6% 2 while in nursing home residents on a skin damage prevention program the incidence was 3.4%. 6 In both LTAC 2 and nursing homes 6 , the time to onset of IAD was approximately two weeks while in critically-ill patients onset was only 4 days. 7 A previous study 8 reported that 52.5% of community-living individuals with fecal or dual incontinence reported a history of IAD and there was no association of a history of IAD with age, gender, or presence of urinary incontinence.…”

Section: Introductionmentioning

confidence: 99%

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Incidence and Characteristics of Incontinence-Associated Dermatitis in Community-Dwelling Persons With Fecal Incontinence

Funk

Jacobson

Savik

2015

Journal of Wound, Ostomy &Amp; Continence Nursing

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Purpose Little is known about the incidence and characteristics of incontinence associated dermatitis (IAD) in community-living individuals with fecal incontinence. The primary aim of this study was to describe the incidence and characteristics of self-reported IAD among community-living individuals with fecal incontinence. The study also examined whether IAD was associated with older age, gender, presence of urinary incontinence, or fecal incontinence severity. Design Secondary data analysis using a prospective cohort design. Subjects and Setting Community-living adults (N = 98) with fecal incontinence (76% female, 34% aged 65+ years, 90% White) who participated in a study about dietary fiber supplementation and were free of IAD at the start. Thirty five percent also had urinary incontinence. Methods Subjects assessed their skin for IAD daily for 52 days reporting types of IAD damage (redness, rash/fungal infection, and skin loss), location of IAD, and symptoms. They reported fecal incontinence on a diary for the first and last 14 study days. Results The incidence of IAD was 41% (40/98). The fecal incontinence severity score for subjects developing IAD was 1.2 higher than those who never had IAD (p < .001). There was no significant association of IAD with age, gender, or dual fecal and urinary incontinence. Incontinence Associated Dermatitis developed within 2 weeks and healed in approximately 1 week. The most common sign and symptom were redness (60% patients) and soreness (78%), respectively. Most subjects (85%) had IAD in one location. Conclusions Assessing for IAD in community-living patients with fecal incontinence is important as IAD is common and causes discomfort. The relatively mild severity of IAD offers WOC nurses opportunity for improving patient outcomes by preventing and managing this problem.

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Section: Discussionsupporting

confidence: 56%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Incidence and Characteristics of Incontinence-Associated Dermatitis in Community-Dwelling Persons With Fecal Incontinence

Funk

Jacobson

Savik

2015

Journal of Wound, Ostomy &Amp; Continence Nursing

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“…The prevalence of faecal incontinence is around 10% in hospital and 30-60% in nursing homes (Halfens et al, 2013). Long et al (2012) presented information on 171 patients admitted to a long-term care facility in Cincinnati, Ohio, USA. 39 had IAD on admission (prevalence of 22.8%).…”

Section: Incidence/prevalence Of Incontinence and Iadmentioning

confidence: 99%

Incontinence-associated dermatitis: reducing adverse events

Rippon

Colegrave²,

Ousey

2016

Br J Nurs

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Incontinence-associated dermatitis (IAD) is a common problem in patients with faecal and/or urinary incontinence. Urine alters the normal skin flora and increases permeability of the stratum corneum and faecal enzymes on the skin contribute to skin damage. Faecal bacteria can then penetrate the skin, increasing the risk of secondary infection. However, IAD can be prevented and healed with timely and appropriate skin cleansing and skin protection. This includes appropriate use of containment devices. HARTMANN incontinence pads have been developed to absorb the fluids that cause IAD and maintain the skin's acidic pH. The acidic pH of the skin contributes to its barrier function and defence against infection. Therefore, maintaining an acidic pH will help protect the skin from damage. Key phrasesThe incidence of IAD in people in long term care, acute care and the community is high.Treatment of IAD increases the cost of providing incontinence care and decreases patients' quality of life.IAD incidence can be significantly reduced by effective preventative measures that involve correct implementation of a structured skin care protocol.Incontinence pads with curly fibre technology may assist with effective skin care protocols to prevent IAD and effective skin care protocols to prevent IAD and have associated benefits for the patient's quality of life and for healthcare providers.

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What characteristics predispose to continence in nursing home residents?: A population‐based cross‐sectional study

Saga

Vinsnes²,

Mørkved

et al. 2014

Neurourol. Urodynam.

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AimsTo compare characteristics of both continent and incontinent residents in Nursing Homes (NHs) and to explore what predicts continence and severity of incontinence.MethodsA population-based cross-sectional study was performed in nursing homes in one Norwegian municipality. Registered nurses filled in a questionnaire on behalf of the patients.ResultsWe found that 25.4% of the NH residents were continent, 31.8% had urinary incontinence alone, 2.6% had fecal incontinence alone and 40.2% had double incontinence. Continent residents were characterized by being in short-term care, shorter stay in NH, less cognitive and physical impairment, less Parkinson's disease, stroke, constipation, and less diarrhea and more independence in activities of daily living (ADL). Residents with fecal incontinence alone were characterized by more diarrhea, less cognitive impairment and less dependency in ADL such as feeding and grooming. Residents with urinary incontinence alone were characterized by having some degree of ADL dependency, less diarrhea, and less diabetes. Residents with double incontinence were characterized by being in long-term care, a longer length of stay in NH, cognitive impairment, stroke, constipation, diarrhea, and dependency in ADL. Severity of incontinence was associated with dependency in ADL and cognitive impairment, diarrhea, length of stay in NH and lower age.ConclusionsAbout 25% of NH residents were continent. Double incontinence and urinary incontinence only were prevalent conditions in NHs, while FI alone was rarer. With the exception of diarrhea as a cause of FI, it appears that FI alone, UI alone, and DI may have common causes and development. Neurourol. Urodynam. 34:362–367, 2015. © 2014 The Authors. Neurourology and Urodynamics published by Wiley Periodicals, Inc.

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Incontinence-Associated Dermatitis in a Long-term Acute Care Facility

Cited by 78 publications

References 9 publications

Incidence and Characteristics of Incontinence-Associated Dermatitis in Community-Dwelling Persons With Fecal Incontinence

Incidence and Characteristics of Incontinence-Associated Dermatitis in Community-Dwelling Persons With Fecal Incontinence

Incontinence-associated dermatitis: reducing adverse events

What characteristics predispose to continence in nursing home residents?: A population‐based cross‐sectional study

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