Incontinence associated dermatitis in elderly people admitted to a university hospital

Impact of an evidence-based bundle on incontinence-associated dermatitis prevalence in hospital patients: A quasi-experimental translational study

The study aimed to evaluate the effect of an intervention on the prevalence and severity of incontinence-associated dermatitis (IAD) in six hospitals in one state in Australia. This quasi-experimental pre-and post-study, conducted in 18 wards, was part of a larger implementation science study on incontinence-associated dermatitis. Skin and incontinence assessments were conducted on patients during February and March 2020 (pre-intervention) and July and August 2021 (post-intervention). The intervention comprised continence assessment and management, an education brochure for patients, family and caregivers on IAD, the Ghent Global IAD Categorisation Tool (GLOBIAD) and a skin care regime with patient skin protection measures (three-in-one barrier cream cloths, minimisation of bed protection layers, use of appropriate continence aid). A total of 1897 patients were assessed (pre-intervention = 964, post-intervention = 933). A total of 343 (35.6%) pre-intervention patients and 351 (37.6%) post-intervention patients had incontinence. The prevalence of hospital-acquired IAD was 6.71% in the pre-intervention group and 4.27% in the post-intervention group; a reduction of 36.3% (p = 0.159) despite higher patient acuity, prevalence of double incontinence and the COVID-19 pandemic in the post-intervention group compared with the pre-intervention group. Our multisite best practice IAD prevention and treatment intervention was able to reduce the prevalence and severity of hospital-acquired IAD, suggesting enduring effectiveness of the intervention.

Risk factors of incontinence-associated dermatitis in older adults: a protocol for systematic review and meta-analysis

INTRODUCTION

Due to their ageing skin, older adults are more likely to develop incontinence-associated dermatitis (IAD). Although previous attempts to look at the risk factors for IAD in older adults were done, methodological barriers hindered an in-depth understanding. By investigating risk factors for IAD in the ageing population, the development of precise clinical interventions and guidance could be facilitated, which in turn would enhance patient care standards for incontinence management in this target group. To address this knowledge gap, this systematic review with meta-analysis aims to explore the major risk elements linked to IAD among older adults.

METHODS AND ANALYSIS

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols are adhered to in this systematic review and meta-analysis. To achieve its objectives, a comprehensive search strategy PubMed, Embase, Web of Science, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Medline, Chinese Scientific Journal Database (VIP database), WanFang Data Knowledge Service Platform, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, along with other relevant sources published until 18 July 2023 in both English and Chinese languages will be performed. The screening of articles, data abstraction and risk of bias evaluation will be done by two impartial reviewers. RevMan V.5.3 software will be used for data synthesis. The quality of the included study will be assessed using the Newcastle-Ottawa Quality Assessment tool and the Agency for Healthcare Research and Quality. The I 2 test will identify the heterogeneity.

ETHICS AND DISSEMINATION

There is no need for ethical approval. Individual patient information or the rights of participants will not be compromised by this protocol. The findings will either be published in a peer-reviewed journal.

PROSPERO REGISTRATION NUMBER

CRD42023442585.

Selective detection of urease-producing bacteria on the genital skin surface in patients with incontinence-associated dermatitis

We aimed to investigate the association between the presence of cutaneous urease-producing bacteria and the development of incontinence-associated dermatitis (IAD) using an original urea agar medium as a step toward developing advanced preventive measures. In previous clinical assessments, we developed an original urea agar medium to detect urease-producing bacteria via the medium's colour changes. In a cross-sectional study, specimens were collected via the swabbing technique at genital skin sites in 52 stroke patients hospitalised in a university hospital. The primary objective was to compare the presence of urease-producing bacteria between the IAD and no-IAD groups. Determining the bacterial count was the secondary objective. The prevalence of IAD was 48%. A significantly higher detection rate of urease-producing bacteria was observed in the IAD group than in the no-IAD group (P = .002) despite the total number of bacteria being equivalent between them. In conclusion, we discovered that there was a significant association between the presence of urease-producing bacteria and IAD development in hospitalised stroke patients.

APPLICATION OF THE DIAPER USE RATING SCALE IN A MEDICAL CLINIC OF A UNIVERSITY HOSPITAL

Objectives:apply the evaluation scale for the use of diapers and absorbent products (AUFA Scale) in patients admitted to the medical clinic; identify and analyze the results of this application, the sociodemographic profile of patients in vogue as well as repercussions on the skin related to the use of sanitary pads and diapers. Method: observational, cross-sectional, descriptive and exploratory study, carried out in the medical clinic sector of the University Hospital Hospital Universitário Clementino Fraga Filho (HUCFF/UFRJ), from November 2019 to February 2020, with a convenience sample of 46 patients. There was application of a form to survey general data and, later, the application of the AUFA scale, which identified the following variables: skin conditions, skin aging, cognitive ability, motor skills and incontinence. Results: all 46 patients were using diapers, half women and the other half men, mostly elderly and without a diagnosis of incontinence. In view of the application and analysis of the AUFA scale, only 18 patients (39.14%) were indicated for diaper use. With the inappropriate use of diapers, 27 patients had skin lesions resulting from moisture, a situation that was justified by the absence of systematic care observation for the prevention and treatment of dermatitis associated with incontinence in the evaluated patients. Conclusion:the use of the AUFA scale is indicated to identify patients who need to wear diapers, delimiting care with their management and thus preventing complications and worsening of incontinence.

APLICAÇÃO DA ESCALA DE AVALIAÇÃO DO USO DE FRALDAS EM UMA CLÍNICA MÉDICA DE UM HOSPITAL UNIVERSITÁRIO

Objetivos:aplicar a escala de avaliação do uso fraldas e absorventes (AUFA) nos pacientes internados na clínica médica; identificar e analisar os resultados dessa aplicação, o perfil sociodemográfico dos pacientes em vogo bem como repercussões à pele relacionadas ao uso de absorventes e fraldas. Método: estudo observacional transversal, descritivo e exploratório, realizado no setor de clínica médica do Hospital Universitário Clementino Fraga Filho (HUCFF/UFRJ), no período de novembro de 2019 a fevereiro de 2020, com amostra por conveniência de 46 pacientes. Ocorreu aplicação de ficha para levantamento de dados gerais e, após, a AUFA, que identificou as seguintes variáveis: condições da pele, envelhecimento da pele, capacidade cognitiva, capacidade motora e incontinências. Resultados: todos os 46 pacientes encontravam-se em uso de fralda, sendo metade mulheres e a outra metade homens, em grande maioria composta de idosos e sem diagnóstico de incontinência. Diante da aplicação e análise da AUFA, apenas 18 pacientes (39,14%) tinham indicação para uso de fraldas. Com o uso inadequado da fralda, 27 pacientes apresentaram lesão de pele decorrente de umidade, situação que se justificou pela ausência da observação de cuidados sistematizados para prevenção e tratamento de dermatite associada à incontinência nos pacientes avaliados. Conclusão: indica-se o uso da escala AUFA para identificar os pacientes que necessitam usar fralda, delimitando cuidados com seu manejo e prevenindo, assim, complicações e agravamentos da incontinência.