The occurrence of skin breakdown among nursing home residents remains of significant concern. Wet/damp skin is more permeable to irritating substances and less friction is needed to abrade or blister the skin when damp. Macerated skin is friable and easily torn, therefore protection of the skin with moisture barriers is important. Maintenance of skin integrity via prevention and early intervention of skin conditions/breakdown, including pressure ulcers (PUs), requires coordinated care and consumes a major portion of caregivers' time and resources in long term care facilities. This study assessed the effectiveness of skin care protocols, including a body wash and skin protectant, on skin breakdown in two nursing homes. Using a quasi-experimental pretest - posttest design, adult residents (n=136) of two skilled nursing homes consented to participate in the study. Seventy percent were female (mean age of 82 years). A three-month pre-intervention incidence of skin conditions was followed by an educational program for nursing staff on study products and protocols. The three-month post-test period followed with study products incorporated into routine cares. Weekly data collection included: incidence, type of skin breakdown or pressure ulcer, urinary or fecal incontinence, and assessment of the effectiveness of body wash and skin protectant. Implementation of a protocol for skin care, including the prophylactic use of a body wash and skin protectant, reduced the prevalence of skin breakdown (pre=74, post=39, p=.007 for agency B) and reduced Stage I and II PU incidence (pre=12.5%, post=5.6%, p=.000). Important is the decrease in the occurrence of perineal dermatitis by nearly half, from 15 pre- to 8 post-intervention, as well as the decrease in skin tears from 32 pre- to 17 post-intervention. Incorporating body wash and skin protectant into skin care prevention and early intervention protocols in nursing homes can significantly reduce the prevalence and incidence of skin breakdowns.
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