I is for 'Incontinence'
This week we will be looking at the ‘I’ of the SSKIN bundle.
It is vital we keep the skin clean and dry. Excess moisture caused by Incontinence is known
as ‘Maceration’ or ‘Incontinence Associated Dermatitis (IAD)’. I have also seen it documented as ‘Moisture Associated Dermatitis (MAD)’. It can become very painful and uncomfortable and has been described to me by patients as a burning type of pain.
Maintain the skin at its natural pH range (between 4 and 7), by using formulated skin products designed for incontinence care. Use a barrier ointment, cream or spray to minimise direct contact with urine and faeces.
Therefore, as part of your care planning incorporate which barrier cream or spray you will be applying and read the manufactures instructions. I remember as a carer putting on huge dollops of the stuff but in reality you generally only require a pea sized amount per application!
A warning of Zinc based antiseptic ointments and creams which a lot of people still apply such as Sudocrem. This can be great for baby bums but not older bums (although some health visitors advised me they do not recommend for baby bums either). The reason being it can clog the wicking layer of the continence product stopping the absorbency and thus I have seen it cause moisture lesions. It can also be difficult to remove. Rubbing of the skin with cleanser and cloth is the most witnessed way of removing the cream but rubbing of the skin is discouraged and in turn may increase the risk of tissue trauma, along with the friction effect caused by rubbing.
So, share this knowledge with your care champions or tissue viability links and ensure care plans include a continence skin integrity care plan, either in the personal care section, barrier cream application or as part of the gold standard SSKIN care plan.
If you need clinical advice feel free to contact me here at OSKA™.