Prevalência de dermatite associada à incontinência

Abstract

Introduction: IAD affect a large proportion of adults, especially the elderly, since the aging increases the risk of skin damage and commonly they present urinary and fecal incontinence. Moisture associated with incontinence is one of the main risk factors for skin lesions and consequent development of IAD. This condition has a negative impact on the patient's life quality and increases the treatment costs. Maintaining skin integrity is one of the nurse's concerns. An effective care plan includes the differential diagnosis, prevention (by gentle cleansing, moisturizing and applying barrier creams), and topical treatment (remove skin irritants, eliminate infection and to contain or divert urine and feces of skin). Given the absence of studies in Portugal on the prevalence of IAD, it was decided to conduct a study in this field. Objective: To estimate the prevalence and incidence of IAD in the medical service of a Central Hospital. Methods: A retrospective epidemiological study was conducted on a hospital environment, more specifically in the Internal Medicine service of a Central Hospital. Data collection was performed consulting the computer system “Glint”, filling out a form prepared for that purpose. The data were collected (three months) in the months of February, March and April 2015. Results: We reviewed the records of 804 patients. The sample was made essentially by patients aged with an average age of 83 old. 58% on the patients were females and the other 42% were males. 85.2% of patients were dependent in a high degree for daily activities. We identified 88 patients with IAD. 58% of IAD were acquired after 24 hours of admission and 42% were acquired at home, which corresponds to 6.6% incidence and 10,95% of prevalence. We obtained a sample of 45 patients with incontinence and a prevalence of incontinence in patients with IAD of 51.1%. We also found a total of 26 incontinent patients with IAD after 24 hours of hospitalization, which amounts to 50.9% incidence rate of IAD in incontinents. The mean duration of the IAD acquired after 24 hours of admission was 8.92 days. The most affected anatomical locations were the perineal region (46.4%), crease between buttocks (28.4%), perianal (25%) and scrotal (24.3%). Conclusions: IAD is a common skin lesion in patients with urinary and / or fecal incontinence. Nursing teams should be formed and trained in the inspection of the perineal skin to standardize the evaluation of the skin and the correct classification of IAD. It is fundamental the registration of patient incontinence type at admission in order to correctly implement the measures that can prevent the development of IAD.

Date of Award	18 Jul 2017
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	João Costa Amado (Supervisor) & Paulo Alves (Supervisor)