title: Incontinence-associated dermatitis in a long-term acute care facility.
abstract: OBJECTIVE
  The objectives of this study were to (1) measure the prevalence of incontinence-associated dermatitis (IAD) and pressure ulcers (PUs) on admission to a long-term acute care (LTAC) facility; (2) identify factors associated with IAD and PU on admission to an LTAC facility; and (3) measure the incidence of incontinence and PUs in LTAC patients.
  
  
  METHODS
  This was a longitudinal, repeated-measures study; data were collected over a 12-week period.
  
  
  METHODS
  One hundred seventy-one patients, with a median age of 55 years. Fifty-four women and 117 men were evaluated. The sample comprises all patients admitted to the 4 LTAC units at the Drake Center in Cincinnati, Ohio.
  
  
  METHODS
  Patients were examined using the "Hospital Survey on Incontinence and Perineal Skin Injury" instrument within 24 hours of admission and they were reevaluated weekly using the same tool until discharge. All data were collected by the Drake Center Advanced Wound Team. Prevalence was defined as the frequency of PUs or IAD identified at admission. Incidence was calculated using the formula: the number of new IAD cases/the number of patients without IAD on admission. Pressure ulcer incidence was measured using 2 formulas: (1) the number of patients with new PUs/the number of all patients who did not have PU on admission and (2) the number of patients with new PUs or a PU in a new location/the number of all patients.
  
  
  RESULTS
  Thirty-nine out of 171 patients had IAD on admission, yielding a prevalence of 22.8%. Sixty of 171 patients had a PU on admission, yielding a prevalence of 35.1%. Ten of 132 patients who did not have IAD at admission developed IAD during follow-ups, yielding a 7.6% incidence. Two PU incidence rates were measured; those patients without PUs on admission 3.6% (4/111) and all patients 8.2% (14/171).
  
  
  CONCLUSIONS
  The LTAC admission PU prevalence rate in this study was greater than that reported previously in acute or long-term care settings. The LTAC PU incidence rate was less than those reported for both acute and long-term care settings. The LTAC IAD admission prevalence rate closely reflected the acute care rate but was substantially higher than the long-term care rate.
authors.affiliation: Roper St Francis Health Care, Charleston, South Carolina 29401, USA. mary.arnoldlong@rsfh.com
authors.forename: Mary Arnold
authors.initials: MA
authors.lastname: Long
authors.forename: Lu Ann
authors.initials: LA
authors.lastname: Reed
authors.forename: Kari
authors.initials: K
authors.lastname: Dunning
authors.forename: Jun
authors.initials: J
authors.lastname: Ying
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D017453:Dermatitis, Irritant / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D005242:Fecal Incontinence / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008134:Long-Term Care; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D003668:Pressure Ulcer / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D015995:Prevalence; D018570:Risk Assessment; D012720:Severity of Illness Index; D012866:Skilled Nursing Facilities; D017592:Skin Care / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000150:complications*