MASD Part 2

Black, Joyce; Gray, Mikel; Bliss, Donna Z; Kennedy-Evans, Karen Lou; Logan, Susan; Baharestani, Mona Mylene; Colwell, Janice C.; Goldberg, Marvin E.; Ratliff, Catherine R.

doi:10.1097/won.0b013e31822272d9

Cited by 111 publications

(39 citation statements)

References 57 publications

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“…As dúvidas estavam relacionadas ao uso de amido de milho e talco para a prevenção ou tratamento da DAI e à diferenciação das lesões semelhantes à DAI, como as LPs. Com relação à possibilidade de utilizar o amido de milho para a DAI, a literatura ressalta que este produto não possui evidência científica para esta finalidade e causa ressecamento da pele, não sendo indicado o seu uso 22 .…”

Section: Avaliaçãounclassified

“…Outra dúvida abordada pela equipe estava relacionada ao uso de talco para a prevenção ou tratamento da DAI. O talco é contraindicado para estas lesões por não haver embasamento científico para esse uso, bem como pode propiciar o crescimento de fungos na pele dos pacientes 22 . A equipe também relatou que muitos profissionais fazem uso de AGE para a DAI, tanto para a prevenção, como para o tratamento.…”

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Ensino sobre dermatite associada à incontinência subsidiado pela metodologia da problematização

2019

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Objetivo: avaliar de modo formativo um processo de intervenção educativa sobre dermatite associada à incontinência com profissionais de enfermagem de um hospital público. Método: estudo de intervenção educativa, com abordagem qualitativa, realizado em 2017, com sete profissionais da equipe de enfermagem do setor de clínica médica, de um hospital universitário da Região Centro-Oeste do Brasil. Investigada amostra não probabilística por conveniência. Os encontros foram gravados na sua totalidade em áudio e para tratamento dos dados utilizou-se a técnica de análise de conteúdo. Estudo aprovado por Comitê de Ética em Pesquisa. Resultados: nos depoimentos foram identificadas as seguintes categorias temáticas: curiosidade epistemológica, pesquisa/investigaçao, avaliação e alegria. Conclusão: os participantes relataram ter compreendido o tema, bem como afirmaram que a condução dos encontros oorreu de forma eficiente, alegre e dinâmica. Destaca-se que os profissionais realizaram discussão sobre o problema, mobilizando o grupo para reflexão e mudança das práticas de cuidados em saúde.

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Section: Avaliaçãounclassified

Ensino sobre dermatite associada à incontinência subsidiado pela metodologia da problematização

2019

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“…1,2 Incontinence associated dermatitis (IAD), has been classified as a type of moisture associated skin damage (MASD) of the superficial skin barrier. 3 It afflicts patients in multiple care settings from critical care to long-term care. 1,4–8 IAD incidence has been reported to be approximately 29% – 36% in critical care patients, 5,6 7% in long-term acute care residents, 7 and 3% to 4% among nursing homes residents on skin damage prevention programs.…”

Section: Introductionmentioning

confidence: 99%

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

Bliss

Mathiason

Gurvich

et al. 2017

Journal of Wound, Ostomy &Amp; Continence Nursing

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Purpose The purpose of this study was to determine the incidence and predictors of incontinence associated dermatitis (IAD) in nursing home residents. Methods Records of a cohort of 10,713 elderly (aged 65+) newly incontinent nursing home residents in 448 nursing homes in 28 states free of IAD were followed for IAD development. Potential multi-level predictors of IAD were identified in four national datasets containing information about the characteristics of individual nursing home residents, nursing home care environment, and communities in which the nursing homes were located. A unique set of health practitioner orders provided information about IAD and the predictors of IAD prevention and pressure injuries in the extended perineal area. Analysis was based on hierarchical logistical regression. Results The incidence of IAD was 5.5%. Significant predictors of IAD were not receiving preventive interventions for IAD, presence of a perineal pressure injury, having greater functional limitations in activities of daily living, more perfusion problems, and lesser cognitive deficits. Conclusion Findings highlight the importance of prevention of IAD and treatment/prevention of pressure injuries. A Wound Ostomy and Continence (WOC) nurse offers expertise in these interventions and can educate staff about IAD predictors which can improve resident outcomes. Other recommendations include implementing plans of care to improve functional status, treat perfusion problems, and provide assistance with incontinence and skin care to residents with milder as well as greater cognitive deficits.

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“…This difference in relative risk may be attributable to higher levels of bacteria and fecal enzymes; diarrhea is usually considered the most significant irritant leading to IAD. Overgrowth of the pathogen Clostridium difficile commonly precipitates an infection that results in frequent or continuous liquid stools, exposing the skin to damaging irritants and wetness 22,23. Incontinence-associated dermatitis carries its own morbidity that includes pain, increased risk of infection of the site, and failure to heal where the skin is denuded (partial-thickness wound), especially in the presence of continued incontinence 1,7…”

Section: Introductionmentioning

confidence: 99%

Clinical Evaluation of a Skin Protectant for the Management of Incontinence-Associated Dermatitis

Brennan

Milne

Agrell-Kann

et al. 2017

Journal of Wound, Ostomy &Amp; Continence Nursing

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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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MASD Part 2

Cited by 111 publications

References 57 publications

Ensino sobre dermatite associada à incontinência subsidiado pela metodologia da problematização

Ensino sobre dermatite associada à incontinência subsidiado pela metodologia da problematização

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

Clinical Evaluation of a Skin Protectant for the Management of Incontinence-Associated Dermatitis

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