Incontinence Management

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By Holly Hovan, MSN, GERO-BC, APRN, CWOCN-AP

Moisture-associated skin damage (MASD) is becoming increasingly prevalent in today’s health care system. Often associated with discomfort and pain, MASD ultimately negatively impacts quality of life. MASD is usually broken down into 3 or 4 categories, most commonly incontinence-associated dermatitis (IAD), intertriginous dermatitis, periwound dermatitis, and peristomal dermatitis. In this blog, I focus on the prevention and treatment of IAD and subsequent pressure injuries in critical care through a nurse-led approach.

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Elizabeth Day Dechant, BSN, RN, CWOCN, CFCN

Diaper rash, more officially known as incontinence-associated dermatitis (IAD), affects hospitalized and incontinent patients of all ages. In my years as a WOC Nurse in a pediatric hospital, IAD has been by far the most frequently treated condition. However, outside of a health care setting, IAD is the most common skin problem in infants and young children who are not yet toilet trained. Diaper rash has plagued babies and new parents for centuries, yet its treatment remains highly debated. For the purpose of this article, I am focusing on the prevention and treatment of diaper rashes in infants and young children, although the principles of topical treatment discussed here apply to all patients.

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by Holly Hovan, MSN, GERO-BC, APRN, CWOCN-AP

The literature suggests that patients with a high degree of adiposity are more at risk for inflammatory conditions, and the numbers of these patients continue to rise. Increased adipose tissue may impact activities of daily living, continence, and overall quality of life (QoL), among other complications. Abdominal (central) obesity may be associated with incontinence, mechanical and neurogenic changes (chronic strain or weakening of nerves in the pelvic area), and skinfold inflammation or irritation.

WoundSource Practice Accelerator's picture

Urinary incontinence is a relatively common condition marked by loss of control of the bladder. In severe cases, it can have a detrimental impact on the quality of life of patients with this condition. Because of the sensitive and embarrassing nature of the topic, urinary incontinence tends to be underreported.

WoundSource Practice Accelerator's picture

Absorbent briefs: Briefs used to absorb urine and stool and to help prevent moisture-associated skin damage in patients with incontinence issues. Briefs with high breathability and wicking help to maintain the skin microclimate.

Barrier products: Creams, sprays, wipes, or other products used to seal the skin and protect it from breakdown caused by moisture or incontinence.

Cyanoacrylates: A skin sealant that bonds to the skin surface and integrates with the epidermis. Cyanoacrylates are strong and resistant to washing off.

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WOC Nursing

Holly Hovan MSN, RN-BC, APRN, ACNS-BC, CWOCN-AP

As you may have already heard, the World Health Organization (WHO) has designated 2020 as the year of the nurse and midwife. The WHO has informed us that in order to achieve universal health coverage by 2030, we need 9 million more nurses and midwives! This is a huge number. Just think, if 9 million more nurses and midwives are needed, how many more wound, ostomy, and continence (WOC) specialists are going to be needed?

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End of Life Skin

By Heidi Cross, MSN, RN, FNP-BC, CWON

Ms. EB, a frail 82-year-old woman admitted to a long-term care facility, had a complex medical history that included diabetes, extensive heart disease, ischemic strokes with left-sided weakness and dysphagia, dementia, kidney disease, anemia, chronic Clostridium difficile infection, and obesity. Her condition was guarded at best on admission, and she had a feeding tube for nutrition secondary to dysphagia. Despite these challenges, she survived two years at the facility.

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By: M. Sanantonio RN, C. Gunner RN, S. Trousaant LVN, M. Moore LVN

It is important for skilled nursing facilities to utilize quality incontinent products for their residents that are facing the daily challenges of both bladder and bowel incontinence. However, products alone do not make for a successful continence management program. It is imperative that the caregivers receive education in multiple areas that ultimately have an effect on the resident’s quality of life, quality outcomes and overall facility cost efficiencies. This study demonstrates the combination of quality incontinent products and education and its overall effectiveness in skilled nursing facilities.

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Margaret Heale's picture
Continence Assessment

By Margaret Heale, RN, MSc, CWOCN

Not very long ago, when working in an in-patient rehab center, I was shocked to discover patients calling the adult incontinence garments "hospital underwear." We were making good inroads into reducing the use of these products with the hope that if we used less it would be possible to acquire higher-quality products that would function optimally for patients who really needed them. It was of concern that some facilities had become diaper-free because many of our patients benefited from briefs, particularly as a "just in case security blanket" and we felt it was unrealistic for our patient population to be brief-free.

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Wound Care Certification

Holly M. Hovan MSN, RN-BC, APRN-CNS, CWOCN-AP

Not many people wake up one day and say, "Wow, I really want to be a continence nurse!" In fact, sometimes people don't even really understand what a continence nurse is, their role, or the specialty in general. I often tell nurses that although we may not all hold certification, every nurse should be a continence nurse, especially in the long-term care setting.