The Effects of Utilizing Clinical Nursing Practice Guidelines for Prevention of Perineal Dermatitis in Neurological Patients with Urinary Incontinence

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Usanee Kaewkab
Wallada Chanruangvanich
Orapan Thosingha
Suporn Danaidutsadeekul

Abstract

Purpose: The purposes of this experimental research were to test effects of clinical nursing practiceguidelines (CNPG) for prevention of perineal dermatitis in neurological patients with urinaryincontinence.

Design: Experimental research.

Methods: The samples included 64 neurological female patients with urinary incontinence whoadmitted at neurosurgery ward, Siriraj Hospital. The experimental group received the CNPG and thecontrol group received routine nursing care. The data were collected by using the general data collectioninstrument for patients and the Visual Grading Scale to assess the severity of dermatitis and dermatitis–free periods. The data were analyzed using t-test and binary univariate logistic.

Main findings: The results revealed that the experimental group had a lower incidence rate andseverity of perineal dermatitis than the control group and a longer dermatitis–free periods than thecontrol group with statistical significance (p < .01). The probability of perineal dermatitis in theexperimental group was equal to 0.05 times compared with the control group (OR = 0.05, 95% CI =0.01-0.18). In addition, the experimental group had an incidence rate of perineal dermatitis of 12.5%;the mean score of severity of perineal dermatitis was 0.31 (SD = .99); and the dermatitis–free period was5.91 days (SD = .53). The control group had an incidence rate of perineal dermatitis of 75 %; the meanscore of severity of perineal dermatitis was 2.03 (SD = 1.42); and the dermatitis–free period was 4.41days (SD = 1.46).

Conclusion and recommendations: The study suggests the benefits of using the CNPG. Nursingstaffs and stakeholders should consider using the CNPG in providing care to neurological patients withurinary incontinence to improve quality of nursing care.

Article Details

How to Cite
Kaewkab, U., Chanruangvanich, W., Thosingha, O., & Danaidutsadeekul, S. (2012). The Effects of Utilizing Clinical Nursing Practice Guidelines for Prevention of Perineal Dermatitis in Neurological Patients with Urinary Incontinence. Nursing Science Journal of Thailand, 29(4), 37–45. Retrieved from https://he02.tci-thaijo.org/index.php/ns/article/view/2842
Section
Research Papers

References

Miller CA. Nursing care of older adults:Theory and practice. Philadelphia: Lippincott; 1999.

Chaleukitti B. Colon and rectal surgery.Bangkok: Rungsilp printing; 2002.

Kochakarn V. Urological diseases of women.Bangkok: Beyond enterprise; 2003.

Thomas TM, Gibson M, George M, Parikshak N, Meade TW. The prevalence of urinary symptoms in patients with chronic neurological disease. Community Med. 1988;10(2):124-9.

Campbell A, Reinken J, McCosk L.Incontinence in the elderly: Prevalence and prognosis. Age Ageing. 1985;14(2):65-70.

McGrother CW, Jagger C, Clarke M,Castleden CM. Handicaps associated with incontinence: Implications for management. J Epidemiol Community Health. 1990;44:246-8.

Dajpratham P, Wechaputi C. Prevalence and correlative factors of post stroke urinary incontinence. Siriraj Med J. 2006;58(12):1208-11.

Cooper P. The use of clinisan in the skin care of the incontinent patient. Br J Nurs. 2000;9(7):445-8.

Junkin J, Selekof JL. Prevalence of incontinence and associated skin injury in the acute care inpatient. J Wound Ostomy Continence Nurs. 2007;34(3):260-9.

Gray M. Prevent and managing perineal dermatitis: A goal for wound and continence care. J Wound Ostomy Continence Nurs. 2004;30(1):S2-S12.

Holloway S, Jones V. The importance of skin care and assessment. Br J Nurs. 2005;14(22):1172-6.

Cooper P, Gray D. Comparison of two skin care regimes for incontinence. Br J Nurs. 2001;10(6):S6-S20.

Fader M, Clarke-O’Neill S, Cook D, Dean G, Brooks R, Cottenden A, et al. Management of night-time urinary incontinence in residential settings for older people: An

investigation into the effects of different pad changing regimes on skin health. J Clin Nurs. 2003;12(3):374-86.

Bare BG, Hinkle JL, Cheever KH, Smeltzer SC. Rehabilitation. In: Theresa lG, editors. Brunner & Suddarth’s textbook of medicalsurgical nursing. Philadelphia: Lippincott Williams & Wilkins; 2008. P.183-91.

Sae-Sia W, Wipke-Tevis DD, Williams DA. The effect of clinically relevant pressure duration on sacral skin blood flow and temperature in patients after acute spinal cord injury. Arch Phys Med Rehab. 2007;88(12):1673-80.

Pajaree K. Rehabilitation of stroke patients. Bangkok: L.T. Press; 2004.

Bliss DZ, Zehrer C, Savik K, Thayer D, Smith G. Feature incontinence-associated skin damage in nursing home residents: A secondary analysis of a prospective,

multicenter study. Ostomy Wound Manage. 2006;52(12):46-55.

Brown DS. Diapers and underpads, part 1: Skin integrity outcomes. Ostomy Wound Manage 1994;40(9):20-8.

Lyder CH, Clemes-Lowrance C, Davis A, Sullivan L, Zucker A. Structured skin care regimen to prevent perineal dermatitis in the elderly. J ET Nurs. 1992;19(1):12-6.

Bates-Jensen B. Chronic wound assessment. Nurs Clin North Am. 1999;34(4):799-845.

Danchaivijitr S, Chokloikaew S, Tangtrakool T, Waithayapiches S. Does indication sheet reduce unnecessary urethral catheterization. Journal of Medical Association of Thailand. 1992;75(2):1-5.

Kidjawan N. The development of a clinical nursing practice guideline for prevention and management of perineal dermatitis in neurological patients with incontinence (Thesis). Bangkok: Mahidol University; 2005. 117 p.

Wongprasert A. The effect of therapeutic nursing on the erythema rash in urinary and/ or fecal incontinence patients (Thesis).Bangkok: Mahidol University; 2005. 81 p.

Hunter S, Anderson J, Hanson D, Thompson P, Langemo D, Klug MG. Clinical trial of a prevention and treatment protocol for skin breakdown in two nursing homes. J Wound Ostomy Continence Nurs. 2003;30

(5):250-8.

Clever K, Smith G, Bowser C, Monroe K. Feature: Evaluating the efficacy of a uniquely delivered skin protectant and its effect on the formation of sacral/buttock pressure ulcers. Ostomy Wound Manage. 2002;48(12): 60-7.

Driver DS. Perineal dermatitis in critical care patients. Crit Care Nurse. 2007;27(4):42-6.

Schnelle JF, Cruise PA, Alessi CA, Al- Samarrai N, Ouslander JG. Individualizing nighttime incontinence care in nursing home residents. Nurs Res. 1998;47(4):197-204.