Incontinence-Associated Dermatitis, Characteristics and Relationship to Pressure Injury: A Multisite Epidemiologic Analysis.
Mikel Gray, Karen K Giuliano
PMID 29300291WHAT IT FOUND
In acute care, skin damage from incontinence was found in 45.7% of incontinent patients, and 73% developed after admission.
It was linked to stool incontinence, urine and stool together, immobility, and facility-acquired sacral pressure injury. Nurses should check skin in these patients.
Key findings
01In acute care, 45.7% of patients with urinary, fecal, or dual incontinence had IAD, and 73% of those IAD cases developed during the hospital stay.
02Patients with fecal incontinence had more IAD than those with urinary incontinence (44.7% vs 29.7%), and immobile patients had more IAD than mobile patients (39.9% vs 7.4%).
03Patients with IAD had more facility-acquired sacral pressure injury (32.3% vs 6.3%) and more facility-acquired full-thickness sacral pressure injury (6.4% vs 1.5%).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The data were collected on one day, so this is a snapshot and cannot show how IAD or pressure injuries developed over time. Survey fields were not mandatory, so missing data may have affected the reported rates. Nurses did not receive specific training in assessing IAD or pressure injury, and no validated instrument was used for IAD severity, so classification may vary. The study used existing quality data and did not compare treatments, so it cannot show that preventing IAD prevents pressure injury. Facilities used a variety of products and interventions, and the units were selected as high risk for pressure injury, so the results may not apply to all acute care patients. The analysis did not establish the timing of IAD relative to pressure injury, so it cannot show which came first.
Declared interests
The supplied text does not report funding or author conflict of interest declarations. The IAD prevalence database was maintained by Sage Products.
The easy way to misread this
Do not conclude that preventing IAD prevents pressure injuries. This was a one-day observational study of existing skin conditions, not a trial of any treatment, and it could not determine whether IAD appeared before pressure injuries or after them.