Incidence and Predictors of Incontinence-Associated Skin Damage in Nursing Home Residents With New-Onset Incontinence.
Donna Z Bliss, Michelle A Mathiason, Olga Gurvich and 10 others
PMID 28267124WHAT IT FOUND
Incontinence-associated skin damage appeared in 5.5% of nursing home residents after new incontinence.
Most cases appeared within 14 days. Prevention orders were the strongest thing linked to lower risk; perineal pressure injury, ADL limits, perfusion problems, and fewer cognitive deficits raised risk.
Key findings
01Among nursing home residents who developed new incontinence after admission, incontinence-associated skin damage occurred in 5.5%, and 89% of those who developed it did so within 14 days of incontinence onset.
02Documented preventive interventions for incontinence-associated skin damage were the strongest protective factor, with odds about half (OR = 0.46; 95% CI: 0.33-0.65) compared with no prevention.
03Greater limitations in activities of daily living, more perfusion problems, a perineal pressure injury at admission, fewer cognitive deficits, and not receiving prevention were significant predictors of developing incontinence-associated skin damage.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Incontinence-associated skin damage was found from written orders, so some cases may have been missed. Incontinence-associated skin damage was not a standardized resident assessment item, so outcome identification depended on wording in records. The study used data from 2000 to 2002, so newer skin-care products and practices were not represented. It included only residents in for-profit nursing homes, so results may not apply to all nursing homes. Staff knowledge, attitudes, and exact incontinence type were not available, and the model did not account for time to development. Because this was observational, the link between prevention orders and lower odds cannot prove prevention caused the lower risk.
The easy way to misread this
Do not conclude that a specific skin-care product prevents incontinence-associated skin damage. The study found lower odds in residents who had prevention documented in orders, but it did not randomise or test products, and many details of care were not measured.