An Economic Evaluation of Four Skin Damage Prevention Regimens in Nursing Home Residents With Incontinence

Bliss, Donna Z; Zehrer, Cindy; Savik, Kay; Smith, Graham C.; Hedblom, Edwin C.

doi:10.1097/01.won.0000264825.03485.40

Cited by 101 publications

(77 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…24 More recent work has focused on the economic benefits of cleansers and provides another dimension to consider when choosing products or developing skin care regimes. 25 Thus any protocols that do exist for skin care tend to be based on clinical experience, rather than empirically derived quality evidence.…”

Section: ■ Introductionmentioning

confidence: 99%

“…19 However, this is less common in North American literature, where the clear distinction between routine cleansing/ hygiene regimes and protocols for the skin care of individuals with urinary or fecal incontinence exists. 25,26 Because patients with urinary and/or fecal incontinence may receive skin care interventions following every incontinence episode, their skin may be subjected to as many as 12 episodes of cleansing within a 24-hour period. The objective of this study was to quantify the effect of standard soap and water skin care practices on the skin's barrier function.…”

Section: ■ Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Effect of Washing and Drying Practices on Skin Barrier Function

Voegeli

2008

Journal of Wound, Ostomy &Amp; Continence Nursing

108

View full text Add to dashboard Cite

PURPOSE:The aim of this study was to explore the potential contribution to skin damage caused by standard washing and drying techniques used in nursing.DESIGN: An experimental cohort design was used, with healthy volunteers (n = 15) receiving 6 different washing and drying techniques to the volar aspect of the forearm. Subjects underwent 3 washing and drying techniques on each arm; each technique was repeated twice, separated by a 2-hour rest period. METHODS:Skin integrity was assessed by measuring transepidermal water loss (TEWL), skin hydration, skin pH, and erythema. Comparisons were made between washing with soap or water alone, and drying using a towel (rubbing and patting) or evaporation. The significance of any difference was assessed by nonparametric analysis. The study was approved by the local research ethics committee, and all volunteers gave informed consent. RESULTS:TEWL was seen to increase following each type of wash, and increased further following repeated washing. Drying of the skin by patting with a towel increased TEWL to give readings identical to those obtained from wet skin. There was an increase in skin pH with all washing and drying techniques, particularly when soap was used. Erythema also increased with repeated washing, particularly when soap was used. No significant changes were observed in skin hydration as measured by a corneometer, although there was a tendency for the values to decrease with washing.CONCLUSIONS: These data suggest that washing with soap and water and towel drying has a significant disrupting effect on the skin's barrier function. There is tentative evidence to suggest that a cumulative effect may exist with damage increasing as washing frequency increases. Drying the skin by patting with a towel offers no advantage to conventional gentle rubbing as it leaves the skin significantly wetter and at greater risk of frictional damage. ■ IntroductionThe promotion and maintenance of skin integrity remains one of the most common challenges facing healthcare professionals. Estimates suggest that basic skin care, consisting of washing and drying patients, accounts for 12% to 17% of total nursing time in a typical acute care setting. 1 However, this activity increases significantly during the care of individuals with urinary or fecal incontinence, as washing and drying forms the cornerstone of skin care for this group, in order to prevent irritation and skin breakdown. Globally it is suggested that over 200 million people suffer from significant urinary incontinence, and therefore are at risk of skin breakdown. 2 In the United Kingdom alone, Durrant and Snape 3 suggest that 50% of nursing home residents have urinary incontinence, and overall incidence rates of 40% to 70% in the UK elderly population are reported by the Royal College of Physicians. 4 Early work by Lyder 5 claimed that perineal dermatitis and skin breakdown occurs in 35% of hospitalized elderly patients with incontinence, rising to 41% of individuals in long-term care settings, demonstrating the significance ...

show abstract

Section: ■ Introductionmentioning

confidence: 99%

Section: ■ Introductionmentioning

confidence: 99%

The Effect of Washing and Drying Practices on Skin Barrier Function

Voegeli

2008

Journal of Wound, Ostomy &Amp; Continence Nursing

108

View full text Add to dashboard Cite

show abstract

“…La utilización de una PBNI como Cavilon ® aporta elementos interesantes desde un punto de vista clínico como es la reducción del número de aplicaciones de producto, con una frecuencia de una vez al día, que en estudios publicados por Bale (15) (17) coinciden en la reducción del número de aplicaciones frente a protocolos estándar y en la reducción del tiempo de aplicación. La reversión y reducción de la dermatitis es un aspecto que presenta una mejoría importante en un 90% de los casos aproximadamente; estos datos concuerdan con el metaanálisis de estudios realizado por Schuren (18) y con los resultados de Bliss (17) en un estudio cuasi experimental en los que se pone de manifiesto la mayor efectividad de Cavilon ® frente a otros productos indicados para el tratamiento de la dermatitis irritativa por incontinencia.…”

Section: Discusión Y Conclusionesunclassified

“…La dermatitis por incontinencia es una secuela de la incontinencia fecal y/o urinaria que se presenta frecuentemente con incomodidad, limitaciones de la protección de la piel y un incremento de los costes de tratamiento, así como una pérdida importante en la calidad de los pacientes afectados (2). El coste de estos procesos es muy elevado, pudiendo llegar a ser de hasta 547 €/año por paciente incontinente , aunque estos costes se pueden ver reducidos de forma considerable planificando cuidados adecuados y aplicando productos de protección para evitar la aparición de procesos irritativos y haciendo un manejo adecuado de la incontinencia (12).…”

Section: Introductionunclassified

Dermatitis irritativa del pañal: Tratamiento local con productos barrera y calidad de vida

et al. 2012

View full text Add to dashboard Cite

RESUMENLos trastornos cutáneos son derivados, en la mayoría de las ocasiones, de agresiones continuas por elementos externos que tiene como respuesta reacciones como la pérdida de lípidos epidérmicos por efecto de la humedad, cambios en el pH cutáneo (alcalinización) y aumento del coeficiente de fricción (denudación) junto al desequilibrio de la flora saprofita de la piel, que se traducen en procesos irritativos y en un aumento de la infecciones fúngicas y bacterianas en la zona expuesta a humedad. Dada la importancia de evaluar la calidad de vida de los pacientes con dermatitis que son tratados con productos barrera no irritantes (PBNI) se ha desarrollado un estudio multicéntrico, con el objetivo de evaluar los aspectos relacionados con la mejora en la calidad de cuidados a pacientes tratados con Cavilon ® que presentaban dermatitis por incontinencia mediante la escala ESCLI. Los pacientes incluidos en el estudio fueron 25. Los resultados muestran una mejora importante de los aspectos evaluados mediante la escala ESCLI sobre la evolución de la dermatitis. Esta escala valora aspectos como el área afectada por el enrojecimiento y la severidad, presentan una reversión del 47% de los casos. La denudación de la piel en la zona del pañal desaparece en el 56% de los casos y la severidad de la denudación que presenta una mejoría del 47%. La valoración del dolor en la zona de incontinencia se reduce en un 76% en la zona de incontinencia y en un 73% al realizar la limpieza de la zona. Las conclusiones del presente estudio ponen de manifiesto que la aplicación de productos formadores de una película barrera no irritante (PBNI) en los pacientes que presentan dermatitis por incontinencia representa una alternativa a los tratamientos convencionales como son las cremas o ungüentos de óxido de cinc o pastas al agua. La reversión y reducción de la dermatitis es un aspecto que presenta una mejoría importante. Los resultados obtenidos que podemos relacionar con la calidad de vida o más concretamente con la mejora del dolor son destacables. PALABRAS CLAVEDermatitis irritativa, dermatitis del pañal, dermatitis por incontinencia, productos barrera, calidad de vida. SUMMARY The skin disorders are derived in most cases continuous injuries by external factors that have how responses the loss of epidermal lipids by the effect of moisture, derived of changes in INTRODUCCIÓNLa piel es un órgano muy dinámico que está en un proceso continuo de alteración y renovación para dar respuesta a estímulos endógenos y exógenos. El proceso de envejecimiento del ser humano hace que existan cambios en la dinámica cutánea, que se manifiesta en muchas ocasiones como una respuesta inflamatoria local y crónica o con la pérdida de continuidad de la piel como resultado de la alteración en su capacidad reparadora (1).Los trastornos cutáneos son derivados en la mayoría de las ocasiones de agresiones continuas por elementos externos, que tienen una respuesta muy variada y que puede ir desde el engrosamiento de la capa córnea (hiperqueratosis), al aumento de la ...

show abstract

“…and Staphylococcus aureus; with fungal infection being very common (Campbell et al, 2016). Infection means IAD takes longer to be successfully treated (Bliss et al, 2007). Cases of IAD result in longer hospital stays (Chatham and Carls, 2012;Lewis-Byers and Thayer, 2002).…”

Section: The Implications Of Iadmentioning

confidence: 99%

Incontinence-associated dermatitis: reducing adverse events

Rippon

Colegrave²,

Ousey

2016

Br J Nurs

View full text Add to dashboard Cite

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.

show abstract

An Economic Evaluation of Four Skin Damage Prevention Regimens in Nursing Home Residents With Incontinence

Cited by 101 publications

References 20 publications

The Effect of Washing and Drying Practices on Skin Barrier Function

The Effect of Washing and Drying Practices on Skin Barrier Function

Dermatitis irritativa del pañal: Tratamiento local con productos barrera y calidad de vida

Incontinence-associated dermatitis: reducing adverse events

Contact Info

Product

Resources

About