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Exploring Incontinence-Associated Dermatitis in a Single Center Intensive Care Unit: A Longitudinal Point Prevalence
Jill Campbell1, Jane-Louise Cook, Anna Doubrovsky
1Jill Campbell, RN, IntCareNsg Cert, BAppSc (Nursing), Grad Dip (Wound Care), PhD, Skin Integrity Services, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Herston, Queensland, Australia; and School of Nursing, Queensland University of Technology, Queensland, Australia. Jane-Louise Cook, RN, BHlthSc (Nursing), Grad Dip (Critical Care Nursing), MN (Intensive Care Nursing), School of Nursing, Queensland University of Technology, Queensland, Australia. Anna Doubrovsky, BSc (Hons), MPH, School of Nursing, Queensland University of Technology, Queensland, Australia. Amanda Vann, RN, Grad Cert Intensive Care Nursing, Grad Cert App Sc (Adult Professional Education), MN (Intensive Care Nursing), Intensive Care Services, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia. Greg McNamara, RN, Grad Cert Critical Care Nursing, Grad Dip Mental Health Nursing, BA (Nursing Science), Intensive Care Services, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia. Fiona Coyer, RN, IntCareNsg Cert, PGCEA, MSc Nursing, PhD, School of Nursing, Queensland University of Technology and Intensive Care Services, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Herston, Queensland, Australia.
Purpose:
The purpose of this study was to provide longitudinal prevalence rates of incontinence-associated dermatitis (IAD) in patients in an intensive care unit (ICU) and to identify patient characteristics associated with IAD development.
Design:
Prospective observational.
Subjects And Setting:
The sample comprised 351 patients aged 18 years and older in a major metropolitan public hospital ICU in Queensland, Australia.
Methods:
All consenting, eligible participants at risk of developing IAD underwent weekly skin inspections to determine the presence of IAD. Data were collected weekly for 52 consecutive weeks. Descriptive statistics described the study sample and logistic regression analysis was used to identify patient characteristics associated with development of IAD.
Results:
The weekly IAD prevalence ranged between 0% and 70%, with IAD developing in 17% (n = 59/351) of ICU patients. The odds of IAD developing increased statistically significantly with increasing age (odds ratio [OR]: 1.029, 95% confidence interval [CI]: 1.005-1.054, P = .016), time in the ICU (OR = 1.104; 95% CI: 1.063-1.147, P < .001), and Bristol Stool chart score (OR = 4.363, 95% CI: 2.091-9.106, P < .001). Patients with respiratory (OR = 3.657, 95% CI: 1.399-9.563, P = .008) and sepsis (OR = 3.230, 95% CI: 1.281-8.146, P = .013) diagnoses had increased odds of developing IAD.
Conclusions:
These data show the high variability of IAD prevalence over a 1-year period. Characteristics associated with the development of IAD in patients in the ICU included older age, longer lengths of ICU stay, incontinent of liquid feces, and having respiratory or sepsis diagnoses.
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