Incidence and Predictors of Incontinence-Associated Skin Damage in Nursing Home Residents With New-Onset Incontinence

Bliss, Donna Z; Mathiason, Michelle A.; Gurvich, Olga V; Savik, Kay; Eberly, Lynn E.; Fisher, Jeremy; Wiltzen, Kjerstie; Akermark, Haley; Hildebrandt, Amanda; Jacobson, Megan; Funk, Taylor; Beckman, Amanda; Larson, Reed

doi:10.1097/won.0000000000000313

Cited by 39 publications

(52 citation statements)

References 34 publications

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“…The prevention and treatment of IAD should be an integral part of prevention and treatment strategies for sacral PUs. In addition to these findings, studies indicate that the presence of sacral PUs is significantly associated with IAD development (Bliss et al, ; Boronat‐Garrido, Kottner, Schmitz, & Lahmann, ), which indicates that further research is needed to better understand the association between IAD and PUs and to investigate the relative timing of IAD and PU occurrence.…”

Section: Discussionmentioning

confidence: 97%

Modifiable patient‐related factors associated with pressure ulcers on the sacrum and heels: Secondary data analyses

Manderlier

Damme

Verhaeghe

et al. 2019

Journal of Advanced Nursing

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Aim To explore factors associated with the presence of category I–IV pressure ulcers on the sacrum and heels. Design Cross‐sectional, secondary data analysis using data collected from the Landelijke Prevalentiemeting Zorgproblemen (LPZ) project, a multicentre prevalence study including nursing home residents and community care clients (N = 4,842) in the Netherlands in 2017. Methods A single binary logistic regression model was designed to identify factors associated with the presence of pressure ulcers. Additionally, a multiple binary logistic regression model including modifiable explanatory factors associated with the presence of pressure ulcers was designed. Results Impaired mobility, friction and shear (evaluated using the Braden Scale) are significantly associated with the presence of both sacral and heel category I–IV pressure ulcers. Incontinence‐associated dermatitis is significantly associated with category I–IV sacral pressure ulcers. Conclusion In pressure ulcer prevention, nursing interventions should focus on frequent repositioning and mobilization while avoiding exposure of the skin to friction and shear. The need to consider incontinence‐associated dermatitis, incontinence and moisture as important factors in pressure ulcer risk assessment is confirmed. Impact Pressure ulcers occur when skin and tissues are deformed between bony prominences and the support surface in a sitting or lying position. They are the result of a complex interaction between direct causal factors and a wide range of indirect factors. Recognition of these factors influences risk assessment guidance and practice. Knowledge of skin‐specific factors at the patient level, modifiable by nursing interventions, enables a better targeted and tailored preventive approach.

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Section: Discussionmentioning

confidence: 97%

Modifiable patient‐related factors associated with pressure ulcers on the sacrum and heels: Secondary data analyses

Manderlier

Damme

Verhaeghe

et al. 2019

Journal of Advanced Nursing

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“…The percentage of nursing home residents receiving Medicaid was 73.8 (15.9) (mean (sd)). The characteristics of the nursing homes and their surrounding communities have been described in detail elsewhere (Bliss, Gurvich, Savik, Eberly, Fisher, et al, 2016). Briefly, the nursing homes were located in communities with diverse racial and ethnic populations, although the percentages of some minorities were small.…”

Section: Resultsmentioning

confidence: 99%

“…The first occurrence of incontinence after nursing home admission was determined by Minimum Data Set records or practitioner orders, whichever was earlier. Methods for defining the incidence of incontinence using Minimum Data Set records (Bliss, Gurvich, Savik, Eberly, Harms, et al, 2015) and for defining incontinence and IASD using practitioner orders have been previously described (Bliss, Gurvich, Savik, Eberly, Fisher, et al, 2016). Practitioner orders of were also searched for IASD prevention on or after the date of incontinence until evidence of the presence of IASD was found or a resident’s practitioner orders ended.…”

Section: Methodsmentioning

confidence: 99%

“…There are reports of racial and ethnic disparities in nursing home prevention interventions that could increase the risk of IASD and led us to question whether there may be disparities in IASD prevention. For example, we have recently reported that there were disparities in prevention of incontinence among Black nursing home residents (Bliss, Gurvich, Savik, Eberly, Wyman, et al, 2015; Bliss, Gurvich, Savik, Eberly, Wyman, et al, 2016). Others have shown that compared to non-Hispanic white residents, all minority groups of nursing home residents studied were less likely to receive medications to prevent stroke, which is associated with incontinence (Christian, Lapane, & Toppa, 2003) and hence IASD.…”

Section: Potential Racial and Ethnic Disparity In Preventing Incontinmentioning

confidence: 99%

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Prevention of Incontinence-Associated Skin Damage in Nursing Homes

et al. 2016

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Racial/ethnic disparities in preventing health problems have been reported in nursing homes. Incontinence is common among nursing home residents and can result in inflammatory-type skin damage, referred to as incontinence associated skin damage (IASD). Little is known about the prevention of IASD and whether there are racial/ethnic disparities in its prevention. This study assessed the proportion of older nursing home residents receiving IASD prevention after developing incontinence after admission (n=10,713) and whether there were racial/ethnic disparities in IASD prevention. Predictors of preventing IASD were also examined. Four national datasets provided potential predictors at multiple levels. Disparities were analyzed using the Peters-Belson method; predictors of preventing IASD were assessed using hierarchical logistic regression. Prevention of IASD was received by 0.12 of residents and no racial/ethnic disparities were found. Predictors of preventing IASD were primarily resident level factors including limitations in activities of daily living, poor nutrition, and more oxygenation problems.

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“…The main symptoms of IAD are erythema and oedema, sometimes accompanied by bullae with serous exudates, erosion, or secondary cutaneous infection . Recent prevalence figures of IAD on hospital wards vary between 4.3% and 32.0% and in nursing homes between 5.2% and 5.5% …”

Section: Introductionmentioning

confidence: 99%

Design and psychometric testing of the attitude towards the prevention of incontinence‐associated dermatitis instrument (APrIAD)

Damme

Hecke

Himpens

et al. 2018

International Wound Journal

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Despite the availability of a range of skin care products for the prevention of incontinence‐associated dermatitis (IAD), prevalence remains high. Nurses' attitude is an important determinant to take into account in quality improvement projects. This study aimed to design a psychometrically test the attitude towards the prevention of incontinence‐associated dermatitis instrument (APrIAD). A prospective psychometric instrument validation study was performed in a convenience sample of 217 Belgian nurses. Construct validity and reliability (internal consistency, stability) were tested. The exploratory factor analysis demonstrated a model consisting of four factors and 14 items: (a) beliefs about the impact of IAD on patients, (b) beliefs about team responsibility to prevent IAD, (c) beliefs about personal responsibility to prevent IAD, and (d) beliefs about the effectiveness of IAD prevention products and procedures. Cronbach's α was 0.72 for factor 1, 0.65 for factor 2, 0.63 for factor 3, and 0.47 for factor 4. The intra‐class correlation coefficient was 0.689 (95% confidence interval [CI] 0.477‐0.825) for the total instrument, 0.591 (95% CI 0.388‐0.764) for factor 1, 0.387 (95% CI 0.080‐0.626) for factor 2, 0.640 (95% CI 0.406‐0.795) for factor 3, and 0.768 (95% CI 0.597‐0.872) for factor 4. Psychometric testing of the APrIAD demonstrated adequate validity and reliability measures.

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Incidence and Predictors of Incontinence-Associated Skin Damage in Nursing Home Residents With New-Onset Incontinence

Cited by 39 publications

References 34 publications

Modifiable patient‐related factors associated with pressure ulcers on the sacrum and heels: Secondary data analyses

Modifiable patient‐related factors associated with pressure ulcers on the sacrum and heels: Secondary data analyses

Prevention of Incontinence-Associated Skin Damage in Nursing Homes

Design and psychometric testing of the attitude towards the prevention of incontinence‐associated dermatitis instrument (APrIAD)

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