Risk Determinants of Incontinence associated dermatitis among Critically Ill Patients.

Abstract

Background: Keeping skin integrity functioning and skin barrier protection is an important aspect of nursing care. ICU patients are susceptible to various skin complications, such as pressure ulcers and moisture-related skin damage. Aim: This study aimed to pinpoint incontinence-associated dermatitis (IAD) risk determinants among ICU patients. Design: A prospective observational research design was conducted. Setting(s): Data collection was done in two general ICUs. Participants: A convenience sample of 200 intensive care inpatients was involved. Tools of data collection: One tool, "Risk Determinants of IAD tool", was used to assess the determinants contributing to IAD. It consisted of three parts, part I used to assess demographic and clinical data; part II used to assess ventilation and hemodynamic patient data, and part III used to assess skin condition. Results: About 60.5% had male gender, with a mean age of 49.51 ± 10.54, and about 69.5.% of the overall sample had IAD. Concerning the severity of IAD, 78.4% had a risk for IAD with no redness and skin intact, 19.4% were categorized as grades I, and 2.2% were categorized as grade II. Conclusion: ICU patients' exposure to several risk factors can damage their skin integrity. It can be concluded that increasing age, female gender, sepsis, neurological disorders, a high score on the perineal assessment scale, fever, hypoalbuminemia, enteral nutrition, wet skin, poor hygiene practice, and watery diarrhoea are associated risk factors for IAD in patients with a critical illness. Recommendation: Early identification and management of IAD should be early by using standardized skin protocols and skin assessment tools.

Prognostic factors for the development of incontinence‐associated dermatitis (IAD): A systematic review

“…Studies were conducted in the United States ( n = 3), 35 , 36 , 37 China ( n = 3), 38 , 39 , 40 Brazil ( n = 1), 41 Australia (n = 1), 42 Spain (n = 1), 43 Belgium (n = 1), 44 Japan (n = 1) 45 and Egypt (n = 1). 46 Ten studies were prospective cohort studies, 35 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 45 , 46 one was retrospective 36 and one was a RCT. 44 Three studies were conducted in long‐term care facilities, 36 , 44 , 45 one in community care 35 and eight in intensive care units (ICUs).…”

“… 44 Three studies were conducted in long‐term care facilities, 36 , 44 , 45 one in community care 35 and eight in intensive care units (ICUs). 37 , 38 , 39 , 40 , 41 , 42 , 43 , 46 Sample sizes ranged from 37 to 381 patients. Detailed descriptions of included studies are shown in Appendix S2 (Table S1 ).…”

“…Studies were conducted in the United States ( n = 3), 35–37 China ( n = 3), 38–40 Brazil ( n = 1), 41 Australia (n = 1), 42 Spain (n = 1), 43 Belgium (n = 1), 44 Japan (n = 1) 45 and Egypt (n = 1) 46 . Ten studies were prospective cohort studies, 35,37–43,45,46 one was retrospective 36 and one was a RCT 44 .…”

“…Ten studies were prospective cohort studies, 35,37–43,45,46 one was retrospective 36 and one was a RCT 44 . Three studies were conducted in long‐term care facilities, 36,44,45 one in community care 35 and eight in intensive care units (ICUs) 37–43,46 . Sample sizes ranged from 37 to 381 patients.…”

“…The study by Bliss et al 36 was excluded from the synthesis because effect estimates were not reported, and it was impossible to recalculate any values from the available data. Similarly, Mohamed Elsayed's study (2023) 46 was omitted from the synthesis as it failed to establish a connection between investigated predictors and our specified outcome of interest.…”