Prevention of Incontinence-Associated Skin Damage in Nursing Homes.
Donna Z Bliss, Olga V Gurvich, Michelle A Mathiason and 6 others
PMID 27586441WHAT IT FOUND
No racial or ethnic disparity was found in documented skin-damage prevention for nursing home residents with new incontinence.
Only 0.12 of residents had prevention ordered.
Key findings
01Only 0.12 of older nursing home residents with new incontinence had documented incontinence-associated skin damage prevention ordered.
02There was no racial or ethnic disparity in documented prevention after comparison with expected rates for White residents.
03Poorer nutrition, more oxygenation problems, and greater deficits in activities of daily living were significant predictors of receiving prevention.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Prevention was measured from practitioner orders, not direct observation of care, and the study assumed orders were implemented. The search algorithms may have missed some prevention orders. The cohort came from a national for-profit nursing home chain, so results may not generalize to non-profit homes. Data were from 2000-2002, and current documentation or practice may differ. Some possible influences, such as nursing home culture, were not available in the datasets. For Asian or Pacific Islander residents, the disparity comparison was close to significance (p=.053), so a small difference cannot be ruled out.
Declared interests
The authors declared no conflict of interest. Donna Z. Bliss has grant funding from Hartmann USA for a separate study measuring skin pH in incontinent nursing home residents exposed to an absorbent product containing Curly Fiber.
The easy way to misread this
Do not read the absence of racial or ethnic disparities as evidence that skin-damage prevention is adequate. Only 0.12 of residents had documented prevention, and the study assumed practitioner orders were implemented without confirming delivery.