Prevention of Incontinence-Associated Skin Damage in Nursing Homes

Abstract

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.

The design and feasibility pilot of a model to guide continence care in Australian residential aged care homes

“…In addition to a lack of assessment, research points to: a lack of resident choice related to continence care 19 ; resident and family dissatisfaction with the quality of continence care 20 ; insufficient time to provide continence care 21 ; low rates of toileting assistance 22 ; a routine approach to bowel management 23 ; the overuse and inappropriate use of aperients 24 ; the indiscriminate use of incontinence products 25 ; polypharmacy 24 ; the overuse of anticholinergic medicines 26,27 ; a lack of prevention and management strategies for incontinence-associated dermatitis 28 ; inappropriate antibiotic use for residents with indwelling urinary catheters 29 ; missed care 30 ; and a lack of education for healthcare professionals about UI 31 .…”

Relationship between dry skin and pressure injury in older patients: A multicentre cross‐sectional survey in China

“…This study found that the overall prevalence of dry skin was 34.4% in 33 769 older patients, especially was 48.3% in LTC facilities, which was basically near to the prevalence of 29.4%–46.9% in Germany hospitals, 6,30‐34 but lower than 58.2%–99.1% of dry skin prevalence in Germany nursing homes 8,10 . This difference may be related to different study populations.…”

“…33,34 Compared with no incontinence, the elderly with urinary incontinence, faecal incontinence and double incontinence increased the risk of pressure injuries by 1.83, 2.14 and 1.78 times (OR 1.83, 2.14 and 1.78), and increased the risk of stage 2+ pressure injuries by 1.94, 2.40 and 2.20 times (OR 1.94, 2.40 and 2.20), The results indicated that incontinence care was important to prevent pressure injuries in the elderly. 33,34 Other associated factors with pressure injuries included lower serum albumin and haemoglobin values, coexistence of two and more chronic diseases, pulmonary dysfunction, male and older age. The possible reasons were that the lower the serum albumin is, the lower plasma colloid osmotic pressure, which will cause tissue oedema and skin tolerance decline; the lower the haemoglobin is, the lower oxygen carrying capacity of red blood cells, which will also cause tissue hypoxia and reduce skin tolerance.…”

Algorithms for prevention and treatment of incontinence-associated dermatitis

“…Algorithms for prevention and treatment of incontinence-associated dermatitis making that have as consequence the reduction of costs with the care provided by health services and the provision of assistance with quality and safety 13,16 .…”