Examining Prevalence and Risk Factors of Incontinence-Associated Dermatitis Using the International Pressure Ulcer Prevalence Survey.
Susan A Kayser, LeeAnn Phipps, Catherine A VanGilder and 1 others
PMID 31276451WHAT IT FOUND
Among 13,615 incontinent patients, 18% had incontinence-associated dermatitis.
Fecal incontinence and fecal management systems had the highest rates. Bed mobility, weight, longer stay, and linen layers were associated with risk.
Key findings
01The final sample included 56,209 adults, including 13,615 incontinent patients, and IAD was documented in 4.3% overall and 18% among incontinent patients.
02IAD prevalence was highest in long-term acute care (9.1%) among all patients and highest among fecal management systems (26%) versus urine-only incontinence (12%).
03Compared with urine-only incontinence, fecal incontinence and fecal management systems had higher odds (OR 1.55 to 1.65), and bed mobility (OR 1.22), 20 kg weight (OR 1.07), 5 days stay (OR 1.11), and linen layer (OR 1.08) had higher odds; age was not significant.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
IAD identification depended on survey coordinators and was not monitored for accuracy, so some cases may have been missed or misclassified. The survey could not distinguish IAD present on admission from facility-acquired IAD. The design cannot show that fecal management systems, linen layers, weight, stay, or mobility caused IAD. The regression model fit poorly, so important risk factors were missing. Facilities choosing the survey may have been more attentive to skin breakdown, which could affect prevalence estimates.
The easy way to misread this
Do not conclude that reducing linen layers or changing fecal management systems prevents IAD. This survey found associations, not tested interventions, and IAD identification was not monitored for accuracy.