June 2019 Wound Ostomy journal
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A descriptive exploratory survey of incontinence-associated dermatitis in the intensive care setting: The ADDrESS study.
Friday, June 28, 2019
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A descriptive exploratory survey of incontinence-associated dermatitis in the intensive care setting: The ADDrESS study.
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Discuss the sample size used in the study.
ReplyDelete- The study used a convenience sample of RN members of the Australian College of Critical Care Nurses. It's comprised of 2500 members. However, only RNs from adult critical care were invited to participate in the survey which reduced the sample size to 1500 RNs.
Discuss the limitations of the article: limited sample size, design flaws, and/or author bias.
- The sample might not accurately represent the total population of critical care RNs in Australia since the RNs who are not members of the ACCN were not included. Another limitation is the low response rate.
M.Danielyan
ReplyDeleteDiscuss the sample size used in the study.
According to the study, there were 111 valid responses comprising responses rates (111/1967) of the total email invitations sent. Data was extracted from Key Surveys.
Discuss the limitations of the article: limited sample size, design flaws, and/or author bias. One limitation is that the data is from a survey not from direct observation, RNs need to recall from memory if something was done, if policy was followed or not which creates bias among the participants.
1. How does this research article compared to our practice, policy and or procedure?
ReplyDeleteThis journal is about the clinical practices of nurses who are members of the Australian College of Critical Care Nurses on how to prevent and manage incontinence associated dermatitis. Nurses recalled different interventions done including application of moisturizer or combination products at the end of the daily bed back. At PSJMC, we use Phytoplex Hydraguard silicone cream and Phytoplex Protectant Z-Gaurd Paste. These products protect the skin of patients at the risk of IAD by avoiding or reducing skin exposure to moisture and irritants. 50% of the nurses recalled applying a pad, under pad or absorbent pad between the patients and sheets. Our policy on the management of skin related to urinary and fecal incontinence includes utilizing pads that pulls the moisture away from the skin. Only one pad under the patience is recommended. The pad should be checked for soiling during hourly rounding and change as necessary. Another intervention implemented is the use of wipes or wash clothes with 3% dimethicone which is efficient in reducing IAD. PSJMC uses Ready Bath Fresh bathing cloths. These cleanse, moisturize, and soothe the skin. In our policy, soft, durable wash clothes with mild pH balance cleansing agent is recommended. Hot water and excess friction should be avoided. Also consider referral to wound care specialist for assessment and treatment recommendation.
2. Discuss the sample size used in the study.
A total of 1967 survey invitations were sent but only 1051 of these were opened with 149 people clicking on the link to the survey in the invitation. The response rate is 5.6% which is slow for this study.
Michelle Rios, ICU RN
ReplyDeleteHow does this research article compare to our practice, policy and/or procedure?
Assessing for, preventing and/or caring for IADs is an everyday practice for PSJMC ICU nurses. IADs not only affect the integrity of the patient’s largest organ, the skin, but it contributes to patient discomfort, pain, and even satisfaction of care. At PSJMC, we have the skin bundle in place (minimizing friction, elevation of heels, use of 1 chuck /1 sheet pad, turning Q2H..etc) to assist in the prevention of PIs but not necessarily a policy or protocol for the prevention and/or treatment of IADs specifically, equivalent to the study findings. Our cleaning products include lotions (hydrogel/Z guard) and wipes (CHG and non CHG) but no barrier sprays. We also do not have a formal way to “grade” the severity of IADs and rely on WOC consults for care recommendations.
Discuss the limitations of the article: limited sample size, design flaws, and/or author bias
One of the limitations of this article was the limited sample size and its focus on just Australian College of Critical Care Nurses members. The sample size of this study was comprised of 111 participants, all members of ACCN. 111 is a good number, however, a total of 1967 invitations were sent and of those 1051 viewed, making it a small 5.6% response rate. Because not all of Australia’s critical care nurses are members of the professional organization, the findings cannot be generalized as the daily practice and/or experiences with IAD for all Australian ICU nurses. It was a very focused and specific group of healthcare providers that chose to engage and participate in the survey.
How does this research article compare to our practice, policy and/or procedure?
ReplyDeleteThis article research compared to our practice, policy and procedure is the producte we use for incontinence care. Also, educating a caregiver and proper documentation of the skin condition each shift for pt's who's Braden score are less than 18 (mild to high risk of pressure ulcer) is necessary. I think 2 nurses to check and document pts's skin condition every shift with Braden score less than 18 will help remind caregivers that we need to pay more attention in prevention of skin breakdown.We know we need to apply skin barrier to incontinent pt's and use an absorbent pads, and we know we need to reposition pt's q 2 hours, we know we need to keep pt clean and dry. These interventions could be time consuming but educating the caregivers re importance of prevention of skin breakdown and giving projects to the staff to allow them to participate and get involved in monitoring would help in prevention of skin breakdown.I agree re taking pictures of the wound will help the caregiver know the difference between IAD from pressure ulcer.
Discuss the limitations of the article: limited sample size, design flaws, and/or author bias
The sample is limited to ICU ACCN Members only. Chart reviews are being made also. The time limitations is also considered and the implementation was delayed due to needing approvals of the best practice plans.Thus, getting an accurate evaluation and outcome of the intervention is compromised .
Ariel Glaze
ReplyDeleteRN
1. Method of Study
After approval from the University Human Research Ethics Committee and ACCCN approval, all members of the ACCCN who had agreed to be contacted for research were invited to participate in a 10 minute survey during January and February 2018. No incentive was provided. Nurses were surveyed regarding the use of Soap, wipes, soft cloth, towel, spray on barrier film, and bowls of water for bed bath and perineal cleansing in regards to incontinet associated dermatitis.
2. Limitations of the Article:
The sample size might not represent the total populations of nurses in the country. It did not survey nurses who were not members of ACCCN. There were low response rate from nurses (since there were no incentives, this is typical). Electronic surveys have 11% lower response rate than paper-based surveys. Also the use of general terms like "soap", "wipe", and "skin protectant" are used, which makes it difficult to define what exact products were used (i.e. zinc barrier ointment versus desitin).
Melissa Bautista
ReplyDelete1) Describe the method used by the author of the study
For this exploratory study a questionnaire was utilized on an online platform called Key Survey. The survey was about 10 minutes long and was available online for 4 weeks. Survey questions focused on participant characteristics, ICU context, and clinical care practices in the prevention and management of IAD.
2) Discuss the sample size used in the study
The study used RN members from Australian College of Critical Care Nurses who had adult ICU experience. Members who worked in coronary care, pediatric, or neonatal ICU's were excluded. 1967 surveys were sent out via email and 111 valid responses were included in results.