Promoting Skin Care for Older Adults

Nursing care in patients with dependency-related skin injuries in the community: a scoping review

PURPOSE

Dependency-related skin injuries (DRSI) occur in people who need a high level of support to carry out day-to-day activities. Owing to the ageing population, the number of people at risk of DRSI is increasing. Most wound care is performed by nurses in the community. This scoping review aimed to identify the extent of literature on nursing care for patients with or at risk of developing DRSI living in their own home.

MATERIALS AND METHODS

A scoping review was conducted.

RESULTS

A total of 28 studies met the inclusion criteria and four main themes emerged: features of the community setting; wound types, causes and management; prevention strategies around aetiology and holistic care; care management and local wound care.

CONCLUSION

Although most wounds occur in and are treated in the community, there is a paucity of research on wounds in this setting. The care of patients with DRSI in the community is complex and prevention according to the individual aetiology of each lesion is the key factor in wound care.

Incontinence-Associated Dermatitis in Older Intensive Care Patients: A Review and Case Report

Background

Incontinence-Associated Dermatitis is a serious skin injury causing suffering, secondary infection, and inducing almost six times more pressure sore than normal skin patients. This moisture and chemical skin irritation is a concern, especially for intensive care unit nurses. This study aimed to review the effective nursing strategy for preventing and caring for incontinence-associated dermatitis in older intensive care unit patients and pilot its feasibility.

Methods

The five databases, including PubMed, Google Scholar, CINAHL Complete, WanFang, and CNKI, were searched, and articles were screened and extracted. The strategies and details of prevention and care for incontinence-associated dermatitis were reviewed and summarized. Finally, selected strategies were applied to five intensive care unit patients with various health conditions and levels of Incontinence-Associated Dermatitis severity.

Results

The literature review found that there is a standardized nursing process for incontinence-associated dermatitis. The prevention and care strategies for incontinence-associated dermatitis include assessment, risk factor management, skin cleaning, skin protection, and health education and training. In actual clinical application, personalized nursing measures can positively impact patients. Five case studies from our pilot confirmed this finding.

Conclusion

Personalized nursing measures can positively impact patients in actual clinical applications. Our five case studies implementing the strategies from the review confirmed this finding. In clinical work, it is recommended to develop personalized nursing programs for specific risk factors of older intensive care unit patients.

Protocol Registration

TCTR20230808004.

The effect of pH-compatible cleansing cloths on skin pH and the development of pressure ulcers

AIM

Skin care plays an important role in the prevention of the development of pressure ulcers. The aim of this study was to determine the effect of skincare with a body pH-compatible cleansing cloth on the development time of pressure ulcers and on skin pH.

METHODS

This experimental research was conducted with 156 patients hospitalized in intensive care clinics of a state hospital between September 2019 and 2020. The sample was calculated with a power of 80% and a significance level of 0.05 (α error) and as a result, 78 elderly patients formed the intervention group and another 78 elderly patients made up the control group. Data were collected using the Elderly Information Form, Braden Risk Assessment Scale, Pressure Ulcer Staging Tool and Skin pH Measurement Form. The pre- and post-care skin pH of both groups was measured with a skin pH meter. P < 0.05 was considered statistically significant.

RESULTS

The average development time for pressure ulcers was 14.9 days in the control group, 18.9 days in the intervention group and the difference was not statistically significant (p > 0.05). Skin pH decreased in the intervention group after the skin care routine was applied, whereas it increased in the control group.

CONCLUSION

It can be said that care of one's skin with a body pH-compatible cleansing cloth has a positive effect on the development time of pressure ulcers and also positively changes the skin pH to acidic.