Validation of Algorithms for Donning and Doffing Personal Protective Equipment during the COVID-19 Pandemic

Introduction The prolonged or incorrect use of facial masks, respirators and glasses or visors results in friction, pressure and shear forces that constantly act on the facial skin, leading to lesions and dermatitis.

Objective To develop and validate algorithms to guide health professionals in the correct use of personal protective equipment (PPE) and indicate preventive measures against skin injuries caused by inappropriate use during the COVID-19 pandemic.

Methods For the develoment of the algorithms, an integrative literature review was performed using the following databases: PubMed, SciELO, and LILACS. The algorithms were evaluated by 59 health professionals (nurses, doctors, and physiotherapists), using the Delphi technique. A content validity index (CVI) was used for the statistical analysis.

Results The experts classified the items of the algorithms from fully inadequate to fully adequate in the first round of consultations, and from partially adequate to fully adequate in the second round. The overall CVI values were of 0.83 and 1.0 in the first and second rounds respectively.

Conclusion The algorithms validated by the expert panel can be used by health professionals when donning and doffing PPE, and to prevent the facial-skin lesions caused by their use.

Prevention and Care for Incontinence-Associated Dermatitis Among Older Adults: A Systematic Review

Background

The prevalent rate of incontinence-associated dermatitis (IAD) trends upward in older populations. Skin breakdown from IAD impacts the quality of life of older adults and reflects the quality of care in hospitals and long-term care facilities. Specific and appropriate interventions for prevention and care are needed. This systematic review aims to review optimal strategies for prevention and care for older adults with IAD.

Methods

PubMed, CINAHL, SCOPUS, Medline, ProQuest, ThaiLIS, ThaiJo, and E-Thesis were searched for articles published between January 2010 and December 2020. Only articles focusing on older adults were included for the review.

Results

Eleven articles met the inclusion/exclusion criteria. Interventions for the prevention and care of IAD among older adults were categorized as assessment, incontinence management/causative factors management, cleansing, application of medical products for both skin moisturizing and skin barrier, body positioning, nutrition promotion, health education and training, and outcome evaluation. Specific prevention and care strategies for older adults with IAD included using specific assessment tools, applying skin cleansing pH from 4.0 to 6.8, body positioning, and promoting food with high protein. Other strategies were similar to those reported for adult patients.

Conclusion

The systematic review extracted current and specific prevention and care strategies for IAD in older adults. The prevention and care strategies from this systematic review should be applied in clinical practice. However, more rigorous research methodology is recommended in future studies, especially in examining intervention outcomes. Nurses and other health professionals should be educated and trained to understand the causes of IAD in older adults and the specific prevention and care strategies for this population. Because older adults are prone to skin damage, and this type of skin breakdown differs from pressure ulcers, the tools for assessment and evaluation, and the strategies for prevention and care require special attention.

Prospero Registration Number

CRD42021251711.

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