This case study describes the nursing management of one case of irritant contact dermatitis from faecal fluid around the peristomal skin of a patient with an ileostomy who presented to the outpatient department 1 month postoperatively. This postoperative complication occurred as a result of the stoma being located within wrinkles in the abdomen, causing the appliance to leak and skin ulceration to develop, which prevented firm adherence of the appliance base plate to the peristomal skin. Furthermore, the patient was very anxious as a result of these complications. In this patient’s case, the initial goals were to assess and address the peristomal skin complications, provide an appliance with convexity that could be fixed with a belt to stabilise the appliance as early as possible, and finally commence strengthening psychological counselling and dietary guidance for the patient and her family. These nursing interventions were found to reduce the incidence of faecal dermatitis complications around the stoma, improve the patient’s quality of life and thus worth applying.
This article reports the results of a global wound care community survey on Kennedy terminal ulcers, skin changes at life’s end, Trombley-Brennan terminal tissue injuries, skin failure and unavoidable pressure injury terminology. The survey consisted of 10 respondent-ranked statements to determine their level of agreement. There were 505 respondents documented. Each statement required 80% of respondents to agree (either “strongly agree” or “somewhat agree”) for the statement to reach consensus. Nine of the 10 statements reached consensus. Comments from two additional open-ended questions were grouped by theme. Conclusions and suggested recommendations for next steps are discussed. This summary is designed to improve clinical care and foster research into current criteria for unavoidable skin changes at the end of life.
Purpose Within our facility the number of surgical procedures resulting in ostomy formation is increasing. Inpatient ostomy care helps patients learn how to care for their ostomy and become as independent as possible to maintain a high quality of life (QoL) following surgery. But more needs to be done to assess patients’ QoL when they return home. This study was designed to support improvement in the QoL for patients living with ostomies post-discharge. It will assist in promoting patients’ full potential and optimal health within the community.
Method The Stoma-QoL Tool was used to evaluate patients’ perception of living with an ostomy at 1, 2, 4, and 8 weeks post-discharge via a telephone survey. The Stoma-QoL Tool contained 20 closed questions to rate QoL. Ostomy education was provided using multiple written and visual aids.
Results There were 28 new ostomy patients who completed the surveys at the stipulated time periods. The highest score achieved in the Stoma-QoL Tool was used an indicator of QoL at each time period. An example of one patient demonstrated a change in score of 28 to 44 between 1 and 8 weeks. Body image and issues related to the ostomy appliance were the main concerns expressed.
Conclusion Quality of life can affect a patient’s well-being, not only physically but also emotionally and socially. Using an ostomy QoL survey, patients were able to quantify their QoL, allowing members of the research team to individualise patients’ care within the Princeton Healthcare System. (IRB Study: BN2332).
Objective To investigate the knowledge, attitude and behaviour of ICU nurses in relation to incontinence-associated dermatitis (IAD) in patients with urinary and bowel incontinence. Following this, to identify and analyse any influencing factors to provide a basis for the formulation of standard preventative procedures and preventative nursing strategies for IAD.
Methods Convenience sampling was used to survey ICU nurses’ knowledge, attitude and behaviour towards IAD. Between September and October 2019, a questionnaire designed by the researchers, that also gathered demographic data on the ICU nurses surveyed, was disseminated by the organisation’s information technology processes to 508 ICU nurses. Data were statistically analysed by SPSS22.0 software.
Results The total score obtainable within the questionnaire of staff knowledge, attitude and behaviour was (73.03±7.18). This score matrix was comprised of the following sub scores: knowledge (7.23±1.40), attitude (22.53±3.21), and behaviour (43.27±5.20). The working years of clinical nurses was the main factor influencing the knowledge, attitude and behaviour scores of ICU nurses’ understanding and management of IAD (p<0.05). Multiple linear regression analysis showed that the standard of the IAD prevention and incidence monitoring processes and daily management of IAD were correlating influencing factors of ICU nurses’ total IAD score (p<0.01).
Conclusion: ICU nurses’ knowledge of IAD improved. Similarly, ICU nurses’ attitudes towards IAD was better; however, there were differences between attitudes and practices of IAD. Managers in ICU should be more cognisant of the aetiology of IAD and ensure ICU nurses are educated in associated pathophysiology, risk factors, prevalence and incidence monitoring and root cause analysis of instances of IAD. Further, managers should promote the use of standard prevention and nursing management processes to reduce the incidence of IAD.