Incidence and Characteristics of Incontinence-Associated Dermatitis in Community-Dwelling Persons With Fecal Incontinence.

Purpose: Little is known about the incidence and characteristics of incontinence-associated dermatitis (IAD) in community-living individuals with fecal incontinence. The primary aim of this study was to describe the incidence and characteristics of self-reported IAD among community-living individuals with fecal incontinence. The study also examined whether IAD was associated with older age, sex, presence of urinary incontinence, or fecal incontinence severity.

Refinement of an instrument for assessing incontinent-associated dermatitis and its severity for use with darker-toned skin.

Purpose: The purpose of this study was to refine an instrument for assessing incontinence-associated dermatitis (IAD) and its severity for use on lighter- and darker-toned skin, the Incontinence-Associated Dermatitis and its Severity Instrument-D (IADS-D), and to test its validity and reliability among WOC nurses.

Methods: Revisions to the existing instrument included examples of colors of normal and IAD-damaged skin that would be observed on light-, medium-, and dark-toned skin using pixels from patient photographs, additional photographs of IAD manifestations on different skin tones, and training materials. Four certified WOC nurse consultants and 2 WOC nurse clinical experts assessed the face and content validity of the IADS-D instrument.

Incontinence-associated dermatitis in critically ill adults: time to development, severity, and risk factors.

Purpose: The purpose of this study was to determine the time to development, severity, and risk factors of incontinence-associated dermatitis (IAD) among critically ill patients with fecal incontinence.

Subjects And Setting: Forty-five patients with a mean age of 49.4 ± 18.

Dry skin in older adults.

Dry skin is a common problem in the older individual due to physiological changes of the aging process as well as chronic health conditions. Dry skin can worsen if management is inappropriate or lacking. Nursing management of dry skin in the elderly is comprehensive including applying topical products to replenish lipids and reduce water loss, maintaining or increasing fluid intake, limiting sun exposure, and reducing symptoms of chronic illnesses.

Comparing community and specialty provider-based recruitment in a randomized clinical trial: clinical trial in fecal incontinence.

Recruitment of participants to clinical trials remains a significant challenge, especially for research addressing topics of a sensitive nature such as fecal incontinence (FI). In the Fiber Study, a randomized controlled trial on symptom management for FI, we successfully enrolled 189 community-living adults through collaborations with specialty-based and community-based settings, each employing methods tailored to the organizational characteristics of their site. Results show that using the two settings increased racial and ethnic diversity of the sample and inclusion of informal caregivers.

Conservative management of fecal incontinence.

Overview: Although fecal incontinence can be both emotionally and socially debilitating, the embarrassment associated with it is so great that it often prevents patients from seeking much needed help from their health care providers. Nursing care begins with case finding and continues through conservative management, which has greatly improved over the past 15 years. This article summarizes the strategies that have proven most effective in uncovering and combating this prevalent yet seldom acknowledged condition.

Re-examination of risk factors for non-Clostridium difficile-associated diarrhoea in hospitalized patients.

Aim: This paper is a report of a study to determine the incidence of non-Clostridium difficile-associated diarrhoea in hospitalized patients and to re-evaluate clinical characteristics and other risk factors related to non-C. difficile-associated diarrhoea.

Background: Numerous factors are thought to be responsible for diarrhoea in hospitalized patients.

Incontinence-associated skin damage in nursing home residents: a secondary analysis of a prospective, multicenter study.

More than half of the nursing home population is incontinent of urine or feces, presenting challenges to perineal skin health. To determine the occurrence and severity of skin damage in nursing home residents with incontinence, a secondary analysis of data collected from a multisite, open-label, quasi-experimental study of cost and efficacy of four regimens for preventing incontinence-associated dermatitis in nursing home residents was performed. Sixteen randomly selected nursing homes from across the US were included in the study.

Prevalence and correlates of perineal dermatitis in nursing home residents.

Background: Perineal dermatitis is an adverse outcome of incontinence, which is common in older nursing home residents; yet knowledge about perineal dermatitis in this population is sorely lacking.

Objectives: To determine the prevalence and significant correlates of perineal dermatitis in older nursing home residents.

Methods: Assessment data from 59,558 records in the Minimum Data Set (MDS) were linked with 2,883,049 orders in the medical record which enabled definition of variables related to perineal dermatitis, identification of cases, and determination of the prevalence of perineal dermatitis.

Community-based recruitment and enrollment for a clinical trial on the sensitive issue of fecal incontinence: the Fiber study.

The recruitment of community-living participants for clinical trials of sensitive topics, when the population is largely hidden and reluctant to self-identify, and the study protocols and procedures intensive, creates significant challenges to researchers. The Fiber Study is an ongoing randomized controlled clinical trial conducted to compare the effectiveness of three dietary fibers with different levels of fermentability for symptom management in community-living adults with fecal incontinence. The researchers developed a staged approach to recruitment using three primary recruitment methods and a three-phase approach to the enrollment process.

Diet strategies used by women to manage fecal incontinence.

Fecal incontinence occurs in community-living women who are elderly, as well as younger women, particularly after vaginal childbirth. Little is known about how women manage fecal incontinence in their everyday lives. Ten women who had fecal incontinence for at least 1 year participated in an audio-taped interview in a phenomenological study.

Preparing a grant proposal--Part 5: Organization and revision.

Translating a research idea into a well-written grant proposal takes planning and commitment. This Spotlight is the fifth in a series by the members of the Center for Clinical Investigation (CCI) of the Wound, Ostomy and Continence Nurses (WOCN) Society. The aim of this series is to facilitate high-quality grant writing and encourage submissions to WOCN's grants program.

Managing fecal incontinence: self-care practices of older adults.

Little is known about the ways in which community-dwelling elderly individuals manage fecal incontinence (FI) in their daily lives. In this study, community-dwelling elderly individuals were surveyed at clinics of a health maintenance organization (HMO) to describe the self-care practices used to manage FI and to examine factors that influenced the number of self-care practices used and the reporting of FI to a health care practitioner. Responses of 242 elderly individuals who reported that they had FI several times per year were analyzed.

Searching the literature by design.

Current nursing knowledge has been generated by studies whose designs range from exploratory to experimental. Searching the literature for a study illustrating a particular design can be a perplexing process. This article explains strategies that are useful in identifying research studies according to the designs used in their methods.

Dietary fiber in conservative management of chronic renal failure.

Conservative management of chronic renal failure has included a variety of dietary manipulations. Supplementation of dietary fiber to reduce adverse symptoms is a novel approach, but whether it can make an effective clinical impact is yet undetermined. This commentary accompanies a brief report of improved well-being during fiber supplementation.

Severity of fecal incontinence in community-living elderly in a health maintenance organization.

An anonymous survey containing questions about the severity of fecal incontinence (FI)--frequency, amount, and type--and its correlates was distributed to community-living elderly at four managed-care clinics. Completed surveys were received from 1,352 respondents whose mean (+/-standard deviation) age was 75 +/- 6 years and 60% of whom were female. Approximately 19% reported having FI one or more times within the past year.

Development of evidence-based protocols for evaluation and management of dysfunctional vascular access devices in interventional radiology.

Assessment and treatment of dysfunctional vascular access devices (VADs) is a mutual responsibility of nurses who use these devices and the interventional radiology (IR) team. Understanding causes of dysfunction, implementing assessment and treatment protocols, and communication between referral areas and the IR team are beneficial to both areas and to the patient. This study describes development of evidence-based protocols, combining research utilization and a quality improvement educational process.