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Abstract(s)
Introdução: As DAI afetam uma elevada percentagem de adultos, em especial idosos, uma vez que o envelhecimento aumenta o risco de danos na pele e é-lhes mais comum apresentarem incontinência urinária e fecal. A humidade, associada à incontinência, é um dos principais fatores de risco para as lesões da pele e consequente desenvolvimento de DAI. Esta condição tem um impacto negativo na qualidade de vida do paciente e aumenta os custos associados ao tratamento. A manutenção da integridade cutânea é uma das preocupações do enfermeiro. Um plano eficaz de cuidados inclui o diagnóstico diferencial, a prevenção (através da limpeza suave, hidratação e aplicação de cremes barreira), e o tratamento tópico (para remover substâncias irritantes da pele, eliminar a infeção e conter ou desviar a urina e fezes da pele). Dada a escassez de estudos em Portugal sobre a prevalência de DAI optou-se pela realização de um estudo deste âmbito. Objetivo: Estimar a prevalência e incidência de DAI no serviço de Medicina de um Hospital Central. Métodos: Foi efetuado um estudo epidemiológico retrospectivo, em contexto hospitalar, no serviço de internamento de Medicina Interna de um Hospital Central. A colheita de dados foi realizada através da consulta do sistema informático Glint com o preenchimento de um formulário elaborado para esse efeito. Foram colhidos os dados (3 meses) referentes aos meses de fevereiro, março e abril de 2015. Resultados: Analisámos os registos de 804 doentes. A amostra foi constituída, essencialmente por doentes envelhecidos com uma média de idades de 83 anos, em que 58% eram do sexo feminino e 42% do sexo masculino. 85,2% dos doentes eram dependentes em grau elevado para as AVD’s. Identificámos 88 doentes com DAI. 58% das DAI foram adquiridas após 24 horas de admissão e 42% foram adquiridas no domicílio, o que corresponde a incidência de 6,6% e a prevalência de 10,95%. Obtivemos uma amostra de 45 doentes com incontinência e uma taxa de prevalência de incontinência nos doentes com DAI de 51,1%. Encontramos ainda um total de 26 doentes incontinentes com DAI após 24h de internamento, o que perfaz uma taxa de incidência de DAI em incontinentes de 50,9%. O tempo médio de evolução das DAI adquiridas após 24 horas de admissão foi de 8,92 dias. As localizações anatómicas mais atingidas foram a região perineal (46,4%), sulco nadegueiro (28,4%), perianal (25%) e escrotal (24,3%). Conclusões: A DAI é uma lesão da pele comum em doentes com incontinência urinária e/ou fecal. As equipas de enfermagem devem ser formadas e treinadas na inspeção da pele perineal para a uniformização da avaliação da pele e para a correta classificação das DAI. É fundamental o registo do tipo de incontinência do doente, aquando da admissão, a fim de condicionar a implementação de medidas que possam evitar o desenvolvimento de DAI.
Introduction: IAD affect a large proportion of adults, especially the elderly, since the aging increases the risk of skin damage and commonly they present urinary and fecal incontinence. Moisture associated with incontinence is one of the main risk factors for skin lesions and consequent development of IAD. This condition has a negative impact on the patient's life quality and increases the treatment costs. Maintaining skin integrity is one of the nurse's concerns. An effective care plan includes the differential diagnosis, prevention (by gentle cleansing, moisturizing and applying barrier creams), and topical treatment (remove skin irritants, eliminate infection and to contain or divert urine and feces of skin). Given the absence of studies in Portugal on the prevalence of IAD, it was decided to conduct a study in this field. Objective: To estimate the prevalence and incidence of IAD in the medical service of a Central Hospital. Methods: A retrospective epidemiological study was conducted on a hospital environment, more specifically in the Internal Medicine service of a Central Hospital. Data collection was performed consulting the computer system “Glint”, filling out a form prepared for that purpose. The data were collected (three months) in the months of February, March and April 2015. Results: We reviewed the records of 804 patients. The sample was made essentially by patients aged with an average age of 83 old. 58% on the patients were females and the other 42% were males. 85.2% of patients were dependent in a high degree for daily activities. We identified 88 patients with IAD. 58% of IAD were acquired after 24 hours of admission and 42% were acquired at home, which corresponds to 6.6% incidence and 10,95% of prevalence. We obtained a sample of 45 patients with incontinence and a prevalence of incontinence in patients with IAD of 51.1%. We also found a total of 26 incontinent patients with IAD after 24 hours of hospitalization, which amounts to 50.9% incidence rate of IAD in incontinents. The mean duration of the IAD acquired after 24 hours of admission was 8.92 days. The most affected anatomical locations were the perineal region (46.4%), crease between buttocks (28.4%), perianal (25%) and scrotal (24.3%). Conclusions: IAD is a common skin lesion in patients with urinary and / or fecal incontinence. Nursing teams should be formed and trained in the inspection of the perineal skin to standardize the evaluation of the skin and the correct classification of IAD. It is fundamental the registration of patient incontinence type at admission in order to correctly implement the measures that can prevent the development of IAD.
Introduction: IAD affect a large proportion of adults, especially the elderly, since the aging increases the risk of skin damage and commonly they present urinary and fecal incontinence. Moisture associated with incontinence is one of the main risk factors for skin lesions and consequent development of IAD. This condition has a negative impact on the patient's life quality and increases the treatment costs. Maintaining skin integrity is one of the nurse's concerns. An effective care plan includes the differential diagnosis, prevention (by gentle cleansing, moisturizing and applying barrier creams), and topical treatment (remove skin irritants, eliminate infection and to contain or divert urine and feces of skin). Given the absence of studies in Portugal on the prevalence of IAD, it was decided to conduct a study in this field. Objective: To estimate the prevalence and incidence of IAD in the medical service of a Central Hospital. Methods: A retrospective epidemiological study was conducted on a hospital environment, more specifically in the Internal Medicine service of a Central Hospital. Data collection was performed consulting the computer system “Glint”, filling out a form prepared for that purpose. The data were collected (three months) in the months of February, March and April 2015. Results: We reviewed the records of 804 patients. The sample was made essentially by patients aged with an average age of 83 old. 58% on the patients were females and the other 42% were males. 85.2% of patients were dependent in a high degree for daily activities. We identified 88 patients with IAD. 58% of IAD were acquired after 24 hours of admission and 42% were acquired at home, which corresponds to 6.6% incidence and 10,95% of prevalence. We obtained a sample of 45 patients with incontinence and a prevalence of incontinence in patients with IAD of 51.1%. We also found a total of 26 incontinent patients with IAD after 24 hours of hospitalization, which amounts to 50.9% incidence rate of IAD in incontinents. The mean duration of the IAD acquired after 24 hours of admission was 8.92 days. The most affected anatomical locations were the perineal region (46.4%), crease between buttocks (28.4%), perianal (25%) and scrotal (24.3%). Conclusions: IAD is a common skin lesion in patients with urinary and / or fecal incontinence. Nursing teams should be formed and trained in the inspection of the perineal skin to standardize the evaluation of the skin and the correct classification of IAD. It is fundamental the registration of patient incontinence type at admission in order to correctly implement the measures that can prevent the development of IAD.
Description
Keywords
Dermatite Prevenção Incontinência Prevalência Incidência Dermatitis Prevention Incontinence Prevalence Incidence