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Trapani S, Villa G, Poliani A, Gnecchi S, Rosa D, Manara DF. Non-Pharmacological Management of Urge Urinary Incontinence in Women between 40 and 65 Years Old: A Systematic Review. NURSING REPORTS 2024; 14:174-196. [PMID: 38251193 PMCID: PMC10801617 DOI: 10.3390/nursrep14010015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 01/03/2024] [Accepted: 01/06/2024] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Urinary incontinence (UI) has been identified as a World Health Organization health priority. In particular, urge UI (UUI) refers to urine leakage associated with a sudden and compelling desire to void urine. It affects quality of life more than other kinds of UI, but it is not always treated adequately. For these reasons, this study aimed to evaluate the effectiveness of conservative treatment practices to counteract UUI in women aged 40-65 years old. METHODS This systematic review was conducted following the Joanna Briggs Institute (JBI) methodology. According to the protocol registered in PROSPERO, a systematic search was carried out in the CINAHL, Embase, PubMed, PsycInfo, Scopus and Web of Science databases up to October 2022, to find primary studies meeting the inclusion criteria. RESULTS Fourteen studies were included. The scientific literature reported different strategies dealing with the problem of UUI, some purely physical, others physical and psycho-educational and others exclusively psychological. CONCLUSION Conservative treatments are useful to aid the reduction in UUI episodes in middle-aged women. However, none of them can be considered more effective than others due to the impossibility of conducting meta-analytical analyses. Further studies comparing the effectiveness of conservative treatments for UUI are needed.
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Affiliation(s)
- Sara Trapani
- Department of Obstetrics and Gynecology, IRCCS San Raffaele Hospital, 20132 Milan, Italy;
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Giulia Villa
- Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.P.); (D.R.); (D.F.M.)
| | - Andrea Poliani
- Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.P.); (D.R.); (D.F.M.)
| | - Silvia Gnecchi
- Department of Onco-Hematology, IRCCS San Raffaele Hospital, 20132 Milan, Italy;
| | - Debora Rosa
- Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.P.); (D.R.); (D.F.M.)
| | - Duilio F. Manara
- Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.P.); (D.R.); (D.F.M.)
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Abraham K, Kanters TA, Wagg AS, Huige N, Hutt E, Al MJ. Benefits of a digital health technology for older nursing home residents. A de-novo cost-effectiveness model for digital health technologies to aid in the assessment of toileting and containment care needs. PLoS One 2024; 19:e0295846. [PMID: 38166006 PMCID: PMC10760782 DOI: 10.1371/journal.pone.0295846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 11/30/2023] [Indexed: 01/04/2024] Open
Abstract
The aim of this study was first, to introduce a comprehensive, de-novo health economic (HE) model incorporating the full range of activities involved in toileting and containment care (T&CC) for people with incontinence, capturing all the potential benefits and costs of existing and future Digital Health Technologies (DHT) aimed at improving continence care, for both residential care and home care. Second, to use this novel model to evaluate the cost-effectiveness of the DHT TENA SmartCare Identifi in the implementation of person-centred continence care (PCCC), compared with conventional continence care for Canadian nursing home residents. The de-novo HE model was designed to evaluate technologies across different care settings from the perspective of several stakeholders. Health states were based on six care need profiles with increasing need for toileting assistance, three care stages with varying degrees of toileting success, and five levels of skin health. The main outcomes were incremental costs and quality-adjusted life years. The effectiveness of the TENA SmartCare Identifi was based primarily on trial data combined with literature and expert opinion where necessary. Costs were reported in CAD 2020. After 2 years, 21% of residents in the DHT group received mainly toileting as their continence care strategy compared with 12% in the conventional care group. Conversely, with the DHT 15% of residents rely mainly on absorbent products for incontinence care, compared with 40% with conventional care. On average, residents lived for 2.34 years, during which the DHT resulted in a small gain in quality-adjusted life years of 0.015 and overall cost-savings of $1,467 per resident compared with conventional care. Most cost-savings were achieved through reduced costs for absorbent products. Since most, if not all, stakeholders gain from use of the DHT-assisted PCCC, widespread use in Canadian residential care facilities should be considered, and similar assessments for other countries encouraged.
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Affiliation(s)
- Katharina Abraham
- Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Tim Andre Kanters
- Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Adrian Stuart Wagg
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
- Gothenburg Continence Research Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Nicole Huige
- Essity Hygiene and Health AB, Gothenburg, Sweden
| | - Edward Hutt
- Medica Market Access Ltd, Tonbridge, United Kingdom
| | - Maiwenn Johanna Al
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
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Cunich M, Barakat-Johnson M, Lai M, Arora S, Church J, Basjarahil S, Campbell JL, Disher G, Geering S, Ko N, Leahy C, Leong T, McClure E, O'Grady M, Walsh J, White K, Coyer F. The costs, health outcomes and cost-effectiveness of interventions for the prevention and treatment of incontinence-associated dermatitis: A systematic review. Int J Nurs Stud 2022; 129:104216. [PMID: 35364428 DOI: 10.1016/j.ijnurstu.2022.104216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 02/23/2022] [Accepted: 02/23/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Incontinence-associated dermatitis is a common, under-recognized painful skin condition associated with poorer quality of life, increased nurse workloads, and costs. OBJECTIVE To systematically review economic evidence for the prevention and treatment of incontinence-associated dermatitis. DESIGN Systematic review of quantitative research. DATA SOURCES PubMed, MEDLINE, EMBASE, Cochrane Library, York Centre for Reviews and Dissemination database, Econlit, Tufts' Cost-Effectiveness Analysis Registry, and Web of Science. REVIEW METHODS A comprehensive search for studies on resource use (costs), health outcomes, and cost-effectiveness of interventions for incontinence-associated dermatitis was conducted. Screening, data extraction, and initial quality assessment were conducted independently by two reviewers, with disagreements/queries regarding quality settled through consensus with the larger team. Quality evaluated using the Consolidated Health Economic Evaluation Reporting Standards checklist and results narratively arranged. FINDINGS Seventeen studies (10 for prevention, one for treatment and six for both prevention and treatment) included. All studies measured resource use from a healthcare provider perspective; 14 quantified resources in monetary terms. Considerable variation existed in the resource use data primarily due to differences in the type of resources counted, selected time horizons, valuation methods, and reporting approaches. Ten studies provided evidence of their intervention to be cost saving (or at least cost avoiding). Five studies on barrier products provided evidence to be cost saving: three for prevention, one for treatment, and one for both prevention and treatment. Two studies of cleanser and barrier products provided evidence to be cost saving for the prevention and treatment of incontinence-associated dermatitis. One study found a cleanser to be a cost saving preventative intervention. One bowel management system was found to be cost saving over time only, and one nurse education intervention was found to be cost saving for preventing and treating incontinence-associated dermatitis. One barrier product was found to be cost-effective for preventing and treating the condition. Finally, one study found a cleanser and barrier product was time saving for prevention. None of the studies incorporated a multi-attribute quality of life measure; however, two studies included person-reported outcome measures for pain. A narrow range of resources (mainly products) were considered, and there was limited information on how they were counted and valued. Analyses relating to heterogeneity among patients/hospital wards or health facilities and uncertainty were lacking. CONCLUSIONS Barrier products are possibly a more cost-effective treatment than others; however, this evidence lacks certainty. Structured health economic evaluations are required for a reliable evidence-base on the interventions for incontinence-associated dermatitis. TWEETABLE ABSTRACT Most incontinence-associated dermatitis studies lack person-reported outcomes, costs beyond product/staff time, and economic evaluation.
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Affiliation(s)
- Michelle Cunich
- Charles Perkins Centre, Faculty of Medicine and Health (Central Clinical School), The University of Sydney, Sydney, New South Wales, Australia; Sydney Institute for Women, Children and their Families, Sydney Local Health District (SLHD), Sydney, New South Wales, Australia; The ANZAC Research Institute, Concord Repatriation General Hospital, Concord, New South Wales, Australia; Sydney Health Economics Collaborative, Sydney Local Health District (SLHD), Sydney, New South Wales, Australia.
| | - Michelle Barakat-Johnson
- Nursing and Midwifery Executive Services, Sydney Local Health District (SLHD), Sydney, New South Wales, Australia; Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia; Centre for Healthcare Transformation, Queensland University of Technology (QUT), Brisbane, Queensland, Australia.
| | - Michelle Lai
- Nursing and Midwifery Executive Services, Sydney Local Health District (SLHD), Sydney, New South Wales, Australia; Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
| | - Sheena Arora
- Centre for Health Economics Research and Evaluation (CHERE), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia.
| | - Jody Church
- Centre for Health Economics Research and Evaluation (CHERE), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia.
| | - Shifa Basjarahil
- Nursing and Midwifery Services, The Sutherland Hospital, South Eastern Sydney Local Health District, Sydney, New South Wales, Australia.
| | - Jayne L Campbell
- Nursing and Midwifery Services, Hunter New England Local Health District, New South Wales, Australia.
| | - Gary Disher
- Strategic Reform and Planning Branch, New South Wales Ministry of Health, Sydney, New South Wales, Australia.
| | - Samara Geering
- Nursing and Midwifery Services, South Western Sydney Local Health District, New South Wales, Australia.
| | - Natalie Ko
- Nursing and Midwifery Services, Concord Repatriation General Hospital, Sydney Local Health District, Sydney, New South Wales, Australia.
| | - Catherine Leahy
- Quality, Clinical Safety and Nursing, Western New South Wales Local Health District, New South Wales, Australia.
| | - Thomas Leong
- Nursing and Midwifery Services, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, New South Wales, Australia.
| | - Eve McClure
- Aged and Chronic Care and Rehabilitation Services, Sydney Local Health District, Sydney, New South Wales, Australia.
| | - Melissa O'Grady
- Aged and Chronic Care and Rehabilitation Services, Sydney Local Health District, Sydney, New South Wales, Australia.
| | - Joan Walsh
- Nursing and Midwifery Services, The Sutherland Hospital, South Eastern Sydney Local Health District, Sydney, New South Wales, Australia.
| | - Kate White
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia; Cancer Care Research Unit, Sydney Local Health District, Sydney, New South Wales, Australia; The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, New South Wales, Australia.
| | - Fiona Coyer
- Centre for Healthcare Transformation, Queensland University of Technology (QUT), Brisbane, Queensland, Australia; Intensive Care Services, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia; School of Nursing, Queensland University of Technology (QUT), Brisbane, Queensland, Australia.
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Dissemond J, Assenheimer B, Gerber V, Hintner M, Puntigam MJ, Kolbig N, Koller S, Kurz P, Läuchli S, Probst S, Protz K, Steiniger A, Strohal R, Traber J, Kottner J. Flüssigkeits‐assoziierte Hautschäden (FAH): Eine
Best Practice
Empfehlung von Wund‐D.A.CH. J Dtsch Dermatol Ges 2021; 19:815-827. [PMID: 34139095 DOI: 10.1111/ddg.14388_g] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 12/01/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Joachim Dissemond
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum, Essen, Deutschland
| | - Bernd Assenheimer
- Schule für Pflegeberufe, Universitätsklinikum, Tübingen, Deutschland
| | - Veronika Gerber
- Schulung und Beratung im Wundmanagement, Spelle, Deutschland
| | | | | | - Norbert Kolbig
- Stabstelle Wundmanagement, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
| | | | - Peter Kurz
- WPM Wund Pflege Management, Bad Pirawarth, Österreich
| | | | | | - Kerstin Protz
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen, CWC - Comprehensive Wound Center, Universitätsklinikum Hamburg, Hamburg, Deutschland
| | | | - Robert Strohal
- Abteilung für Dermatologie und Venerologie, Landeskrankenhaus Feldkirch, Feldkirch, Österreich
| | - Jürg Traber
- Chirurgie/Gefässchirurgie FEBVS, Phlebologie SGP, Venenklinik Bellevue, Kreuzlingen, Schweiz
| | - Jan Kottner
- CharitéCentrum 1 für Human- und Gesundheitswissenschaften, Charité -Universitätsmedizin Berlin, Berlin, Deutschland
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Dissemond J, Assenheimer B, Gerber V, Hintner M, Puntigam MJ, Kolbig N, Koller S, Kurz P, Läuchli S, Probst S, Protz K, Steiniger A, Strohal R, Traber J, Kottner J. Moisture-associated skin damage (MASD): A best practice recommendation from Wund-D.A.CH. J Dtsch Dermatol Ges 2021; 19:815-825. [PMID: 33942514 DOI: 10.1111/ddg.14388] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 12/01/2020] [Indexed: 11/25/2022]
Abstract
Wund-D.A.CH., as the umbrella organization of German-speaking wound treatment societies, has currently developed a best practice recommendation for skin damage caused by body fluids, which is known as moisture-associated skin damage (MASD) in English-speaking countries. In this expert consensus, the diseases incontinence-associated dermatitis (IAD), intertriginous dermatitis, including intertrigo, gram-negative bacterial toe web infection and toxic contact dermatitis, including periwound and peristomal dermatitis are presented in a differentiated manner. A common feature of these clinical diseases is a deterioration of skin integrity due to prolonged exposure to body fluids such as urine, stool, sweat or wound exudate with associated physical-irritative and/or chemical irritation. In addition, other comorbidities and cofactors play an important role. The diagnosis of these interdisciplinary and interprofessionally relevant MASD is difficult in everyday clinical practice because there are currently no uniform definitions and many relevant differential diagnoses. Effective strategies for the prevention and therapy of these skin diseases are, for example, continence management, use of efficient, absorbent aids with good retention as well as consistent skin protection and adequate skin care. Another important aspect is the education of patients and relatives about the origin, treatment and prevention of MASD.
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Affiliation(s)
- Joachim Dissemond
- Department of Dermatology, Venereology and Allergology, University Hospital Essen, Germany
| | | | - Veronika Gerber
- Training and Consulting for Wound Management, Spelle, Germany
| | | | | | - Norbert Kolbig
- Office for Wound Management, University Hospital Düsseldorf, Germany
| | | | - Peter Kurz
- WPM Wound Care Management, Bad Pirawarth, Austria
| | - Severin Läuchli
- Dermatology Department, University Hospital, Zurich, Switzerland
| | | | - Kerstin Protz
- Institute for Health Services Research in Dermatology and Nursing, CWC - Comprehensive Wound Center, University Hospital Hamburg, Germany
| | | | - Robert Strohal
- Department of Dermatology and Venereology, State Hospital Feldkirch, Austria
| | - Jürg Traber
- Surgery/Vascular Surgery FEBVS, Phlebology SGP, Vein Hospital Bellevue, Kreuzlingen, Switzerland
| | - Jan Kottner
- Charité Centrum 1 for Human and Health Sciences, Charité -University Hospital Berlin, Germany
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Raepsaet C, Fourie A, Van Hecke A, Verhaeghe S, Beeckman D. Management of incontinence-associated dermatitis: A systematic review of monetary data. Int Wound J 2020; 18:79-94. [PMID: 33236846 PMCID: PMC7948709 DOI: 10.1111/iwj.13496] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 08/12/2020] [Accepted: 08/13/2020] [Indexed: 12/13/2022] Open
Abstract
The objective was to systematically review monetary data related to management of incontinence‐associated dermatitis (IAD) in an adult population. Six electronic databases were searched: MEDLINE, CINAHL, Web of Science, EMBASE, The Cochrane Library and EconLit. The search string combined index terms and text words related to IAD and monetary data. The quality of the articles was assessed using the consensus on Health Economic Criteria. Results were synthesised narratively because of methodological heterogeneity. Nine studies were included. Only direct medical costs were reported. The product cost per application for prevention ranged between $0.05 and $0.52, and for treatment between $0.20 and $0.35. The product cost per patient/day for prevention ranged between $0.23 and $20.17. The product cost of IAD prevention and treatment per patient/day ranged between $0.57 and $1.08. The cost to treat IAD did not consider the treatment of secondary infection. The calculation of labour cost and total cost differed considerably between studies. Summarising monetary data is a challenge because of heterogeneity in currencies, settings, samples, time horizons, health‐ and cost outcome valuation, IAD definition and measurements, and included costs. Procedures for health economic evaluations are to be clarified to guarantee valid interpretation and comparison with other studies.
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Affiliation(s)
- Charlotte Raepsaet
- Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Anika Fourie
- Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Ann Van Hecke
- Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Sofie Verhaeghe
- Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Dimitri Beeckman
- Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.,School of Health Sciences, Örebro University, Örebro, Sweden.,School of Nursing & Midwifery, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.,Research Unit of Plastic Surgery, Department of Clinical Research, Faculty of Health Sciences, Vejle, Denmark.,School of Nursing and Midwifery, Monash University, Melbourne, Australia
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Bebiş H, Moorhead S, Gençbaş D, Özdemir S, Seven M. NOC/NIC Linkages to NANDA-I for Continence Care of Elderly People with Urinary Incontinence in Nursing Homes: A Systematic Review. Florence Nightingale Hemsire Derg 2019; 27:284-303. [PMID: 34267982 DOI: 10.26650/fnjn386150] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 05/17/2019] [Indexed: 11/20/2022] Open
Abstract
Aim The aim of this study was to review interventional studies conducted by nurses about elderly people with urinary incontinence in nursing homes and to match the results to standardized nursing terminology using the Nursing Interventions Classification and the Nursing Outcomes Classification Linkages to the NANDA-I diagnoses guidelines. Method A systematic review of quantitative intervention studies was conducted using the PRISMA statement as a guide. The interventional research in English was scanned using the MEDLINE and CINAHL databases from January 2005 to May 2015. Fourteen studies that had at least one nurse researcher were conducted in nursing homes, excluding surgical and pharmacological interventions. The Nursing Outcome Classification and Nursing Intervention Classification Linkages to NANDA-I diagnoses and the Clinical Conditions Part II-U List were used as a guide to select North American Nursing Diagnosis Association International nursing diagnoses, Nursing Outcome Classification Scales, and Nursing Interventions from the data. Results We found the frequency of use of various NANDA-I diagnoses, Nursing Interventions, and Nursing Outcomes based on the Nursing Outcomes Classification and Nursing Interventions Classification Linkages to NANDA-I diagnoses and the Clinical Conditions List for incontinence. Conclusion Using the Nursing Outcomes Classification and Nursing Interventions Classification Linkages to NANDA-I diagnoses guide may provide new nursing perspectives on non-standardized research. In future studies, this may allow a comparison of data worldwide, enabling nurses to use the results in evidence-based practices.
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Affiliation(s)
- Hatice Bebiş
- Department of Public Health Nursing, Near East University, Nicosia, Cyprus
| | - Sue Moorhead
- The University of Iowa College of Nursing, Iowa City, Iowa, USA
| | - Dercan Gençbaş
- Department of Nursing, Atılım University Faculty of Health Sciences, Ankara, Turkey
| | - Serpil Özdemir
- Department of Public Health Nursing, Gülhane Faculty of Nursing Health Science University, Ankara, Turkey
| | - Memnun Seven
- Department of Obstetric and Gynecologic Nursing, Koç University, İstanbul, Turkey
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10
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McNichol LL, Ayello EA, Phearman LA, Pezzella PA, Culver EA. Incontinence-Associated Dermatitis: State of the Science and Knowledge Translation. Adv Skin Wound Care 2018; 31:502-513. [DOI: 10.1097/01.asw.0000546234.12260.61] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Abstract
BACKGROUND: Protecting the skin against moisture-associated damage is an important component of comprehensive skin and wound care. Based on a review of literature, the authors propose key interventions to protect and prevent damage in the skin folds, perineum, and areas surrounding a wound or stoma. OBJECTIVE: The aim of this scoping review is to identify and provide a narrative integration of the existing evidence related to the management and prevention of moisture-associated skin damage (MASD). METHODS: Study authors searched several databases for a broad spectrum of published and unpublished studies in English, published between 2000 and July 2015. Selected study information was collated in several different formats; ultimately, key findings were aggregated into a thematic description of the evidence to help generate a set of summative statements or recommendations. RESULTS: Based on inclusion criteria, 37 articles were considered appropriate for this review. Findings included functional definitions and prevalence rates of the 4 types of MASD, assessment scales for each, and 7 evidence-based strategies for the management of MASD. CONCLUSIONS: Based on this scoping review of literature, the authors propose key interventions to protect and prevent MASD including the use of barrier ointments, liquid polymers, and cyanoacrylates to create a protective layer that simultaneously maintains hydration levels while blocking external moisture and irritants.
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12
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Avşar P, Karadağ A. Efficacy and Cost-Effectiveness Analysis of Evidence-Based Nursing Interventions to Maintain Tissue Integrity to Prevent Pressure Ulcers and Incontinence-Associated Dermatitis. Worldviews Evid Based Nurs 2017; 15:54-61. [DOI: 10.1111/wvn.12264] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Pınar Avşar
- Research Assistant, Department of Nursing, Faculty of Health Science; Yıldırım Beyazıt University; Ankara Turkey
| | - Ayişe Karadağ
- Professor, ET/WOCN, and Director, Department of Nursing, Faculty of Health Science; Koc University; Ankara Turkey
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13
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Development of an Animal Model for Inducing Various Degrees of Severity of Incontinence-Associated Dermatitis. J Wound Ostomy Continence Nurs 2017; 44:578-582. [DOI: 10.1097/won.0000000000000370] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Clinical Evaluation of a Skin Protectant for the Management of Incontinence-Associated Dermatitis: An Open-Label, Nonrandomized, Prospective Study. J Wound Ostomy Continence Nurs 2017; 44:172-180. [PMID: 28267125 PMCID: PMC5344181 DOI: 10.1097/won.0000000000000307] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE: The purpose of this study was to evaluate the efficacy of an investigational skin protectant product at managing severe skin breakdown associated with incontinence. DESIGN: Open-label, nonrandomized, prospective study. SUBJECTS AND SETTING: The sample comprised 16 patients; inclusion criteria were: patients older than 18 years, cared for in the intensive care unit of a level I trauma center hospital or in long-term care facilities in the northeast region of the United States, and had incontinence-associated dermatitis (IAD). Twelve of the patients had epidermal skin loss and 4 had severe redness. METHODS: The investigational product is a formulation based on acrylate chemistry. The skin protectant application schedule was twice weekly for up to 3 weeks for a maximum of 6 applications during the study period. The skin was evaluated via a skin assessment instrument specifically designed for use in this study; this instrument has not undergone validation studies. The main outcome measure was changes in the instrument score over time. In addition, complete reepithelialization was recorded when observed, and pain scores (associated with IAD) were noted in participants who were able to report pain. RESULTS: The IAD score improved in 13 of 16 patients, remained unchanged in 1 patient, and deteriorated in 2 patients. The median percent improvement in the skin assessment instrument was 96% (P = .013). Four of the patients with epidermal skin loss had complete reepithelialization of the skin surface with 4 to 6 applications of the skin protectant, and 5 had substantial improvement. The 4 patients with severe red skin returned to healthy normal skin with 2 to 4 skin protectant applications. Substantial pain reduction was reported by all 9 patients who reported pain at enrollment. No adverse events associated with the skin protectant application were reported during data collection. CONCLUSION: Results of this study suggest that an acrylate-based product, evaluated here for the first time in patients, may be effective as a protective barrier in the presence of continued incontinence. Additional research is needed to confirm these findings.
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Gencbas D, Bebis H, Cicek H. Evaluation of the Efficiency of the Nursing Care Plan Applied Using NANDA, NOC, and NIC Linkages to Elderly Women with Incontinence Living in a Nursing Home: A Randomized Controlled Study. Int J Nurs Knowl 2017; 29:217-226. [DOI: 10.1111/2047-3095.12180] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 05/08/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Dercan Gencbas
- Atilim University; Faculty of Health Sciences; Department of Nursing; Ankara Turkey
| | - Hatice Bebis
- Near East University; Faculty of Nursing; Nicosia Cyprus
| | - Hatice Cicek
- Nursing High School; Girne American University; Girne Cyprus
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Scientific and Clinical Abstracts From the WOCN® Society's 49th Annual Conference. J Wound Ostomy Continence Nurs 2017. [DOI: 10.1097/won.0000000000000331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kim GS, Kim EG, Shin KY, Choo HJ, Kim MJ. Combined pelvic muscle exercise and yoga program for urinary incontinence in middle-aged women. Jpn J Nurs Sci 2015; 12:330-9. [DOI: 10.1111/jjns.12072] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 11/09/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Gwang Suk Kim
- Nursing Policy Research Institute, College of Nursing; Yonsei University; Seoul Jeollabuk-do Rep of Korea
| | - Eun Gyeong Kim
- Department of Nursing; Kunsan National University; Gunsan Jeollabuk-do Rep of Korea
| | - Ki Young Shin
- Hong-ik Yoga Association; Seoul Jeollabuk-do Rep of Korea
| | - Hee Jung Choo
- Department of Urology; Ewha Woman's University, Mokdong Hospital; Seoul Jeollabuk-do Rep of Korea
| | - Mi Ja Kim
- College of Nursing; University of Illinois at Chicago; Chicago Illinois USA
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Incontinence-associated dermatitis: consensus statements, evidence-based guidelines for prevention and treatment, and current challenges. J Wound Ostomy Continence Nurs 2012; 39:303-15; quiz 316-7. [PMID: 22572899 DOI: 10.1097/won.0b013e3182549118] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In 2010, an international consensus conference was held to review current evidence regarding the pathology, prevention, and management of incontinence-associated dermatitis (IAD). The results of this literature review were published in a previous issue of this Journal. This article summarizes key consensus statements agreed upon by the panelists, evidence-based guidelines for prevention and management of IAD, and a discussion of the major challenges currently faced by clinicians caring for these patients. The panelists concur that IAD is clinically and pathologically distinct from pressure ulcers and intertriginous dermatitis, and that a consistently applied, structured, or defined skin care program is effective for prevention and management of IAD. They also agreed that differential assessment of IAD versus pressure ulceration versus intertriginous dermatitis remains a major challenge. Panel members also concur that evidence is lacking concerning which products and protocols provide the best outcomes for IAD prevention and treatment in individual patients. Issues related to differential assessment, product labeling and utilization, staff education, and cost of care are the primary focus of this article.
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