title: Does skin care frequency affect the severity of incontinence-associated dermatitis in critically ill patients?
abstract: BACKGROUND
  Incontinence-associated dermatitis (IAD) is a potentially serious skin injury that can lead to pressure ulcers (PUs). Multiple studies have indicated the need for evidence to find the most effective skin care protocol to reduce the incidence and severity of IAD in critically ill patients.
  
  
  OBJECTIVE
  To compare the incidence and severity of IAD in two groups on a progressive care unit (PCU) using a defined skin care protocol: cleaning with a gentle cleanser and moisturizer, then applying a skin protectant/barrier. The control group received the skin care protocol every 12 hours and the interventional group received the protocol every 6 hours; both groups also received it as needed.
  
  
  METHODS
  A 9-month randomized prospective study was conducted on 99 patients (N = 55 in the intervention group and N = 44 in the control group) who were incontinent of urine, stool, or both, or had a fecal diversion device or urinary catheter for more than 2 days.
  
  
  RESULTS
  The dermatitis score in the intervention group on discharge was significantly less (7.1%; P ≤ 0.001) in the moderate IAD group than in the control group (10.9%). The dermatitis score means and P values of each group were compared using a paired t test.
  
  
  CONCLUSIONS
  The researchers studied a defined skin care protocol using a cleanser with aloe vera and a cleansing lotion, followed by application of either a moisture barrier with silicone or skin protectant with zinc oxide and menthol, undertaken at two different frequencies. Data revealed the incidence of moderate IAD was decreased in the experimental group (receiving the skin protocol every 6 hours and p.r.n.).
authors.affiliation: At Research Medical Center in Kansas City, Mo., Patricia Conley is a staff nurse in the PCU, David McKinsey is an infectious diseases physician, Olwyn Ross is a wound care and ostomy nurse, and Jennifer Feeback is the division director of clinical research. Anthony Ramsey is the director at Radford University School of Nursing in Radford, Va.
authors.forename: Patricia
authors.initials: P
authors.lastname: Conley
authors.forename: David
authors.initials: D
authors.lastname: McKinsey
authors.forename: Olwyn
authors.initials: O
authors.lastname: Ross
authors.forename: Anthony
authors.initials: A
authors.lastname: Ramsey
authors.forename: Jennifer
authors.initials: J
authors.lastname: Feeback
mesh_terms: D000368:Aged; D016638:Critical Illness; D003872:Dermatitis / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D005242:Fecal Incontinence / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D015403:Nursing Evaluation Research; D011446:Prospective Studies; D012720:Severity of Illness Index; D017592:Skin Care / Q000451:nursing / Q000706:statistics & numerical data*; D014549:Urinary Incontinence / Q000150:complications*