Impact of an evidence-based bundle on incontinence-associated dermatitis prevalence in hospital patients: A quasi-experimental translational study.

The study aimed to evaluate the effect of an intervention on the prevalence and severity of incontinence-associated dermatitis (IAD) in six hospitals in one state in Australia. This quasi-experimental pre-and post-study, conducted in 18 wards, was part of a larger implementation science study on incontinence-associated dermatitis. Skin and incontinence assessments were conducted on patients during February and March 2020 (pre-intervention) and July and August 2021 (post-intervention). The intervention comprised continence assessment and management, an education brochure for patients, family and caregivers on IAD, the Ghent Global IAD Categorisation Tool (GLOBIAD) and a skin care regime with patient skin protection measures (three-in-one barrier cream cloths, minimisation of bed protection layers, use of appropriate continence aid). A total of 1897 patients were assessed (pre-intervention = 964, post-intervention = 933). A total of 343 (35.6%) pre-intervention patients and 351 (37.6%) post-intervention patients had incontinence. The prevalence of hospital-acquired IAD was 6.71% in the pre-intervention group and 4.27% in the post-intervention group; a reduction of 36.3% (p = 0.159) despite higher patient acuity, prevalence of double incontinence and the COVID-19 pandemic in the post-intervention group compared with the pre-intervention group. Our multisite best practice IAD prevention and treatment intervention was able to reduce the prevalence and severity of hospital-acquired IAD, suggesting enduring effectiveness of the intervention.

Effects of Outdoor-Grown Royal Sun Medicinal Mushroom Agaricus brasiliensis KA21 (Agaricomycetes) Fruiting Body on Canine Malassezia Dermatitis.

Brazil-grown outdoor-cultivated Agaricus brasiliensis KA21 fruiting body (KA21) significantly increases the production of serum anti-beta-glucan antibody. Therefore, KA21 ingestion may be useful for the prevention and alleviation of fungal infections. This study aimed to determine the effects of KA21 in fungal infections in animals. KA21 was administered to nine dogs infected with Malassezia. Notably, the anti-beta-glucan antibody titer remained unchanged or tended to decrease in the oral steroid arm, whereas in the non-steroid arm, antibody titer increased in almost all animals after KA21 ingestion. Dogs showing improved clinical symptoms exhibited increased anti-beta-glucan antibody titers. The results of this study suggest that KA21 ingestion may alleviate the symptoms of Malassezia and other fungal infections and that continuous ingestion may help prolong recurrence-free intervals. Additionally, the ingestion of KA21 during oral steroid dosage reduction or discontinuation may enable smoother steroid withdrawal.

Immunization of turkeys with Clostridium septicum alpha toxin-based recombinant subunit proteins can confer protection against experimental Clostridial dermatitis.

Clostridial dermatitis (CD), caused by Clostridium septicum, is an emerging disease of increasing economic importance in turkeys. Currently, there are no effective vaccines for CD control. Here, two non-toxic domains of C. septicum alpha toxin, namely ntATX-D1 and ntATX-D2, were identified, cloned, and expressed in Escherichia coli as recombinant subunit proteins to investigate their use as potential vaccine candidates. Experimental groups consisted of a Negative control (NCx) that did not receive C. septicum challenge, while the adjuvant-only Positive control (PCx), ntATX-D1 immunization (D1) and ntATX-D2 immunization (D2) groups received C. septicum challenge. Turkeys were immunized subcutaneously with 100 µg of protein at 7, 8 and 9 weeks of age along with an oil-in-water nano-emulsion adjuvant, followed by C. septicum challenge at 11 weeks of age. Results showed that while 46.2% of birds in the PCx group died post-challenge, the rate of mortality in D1- or D2-immunization groups was 13.3%. The gross and histopathological lesions in the skin, muscle and spleen showed that the disease severity was highest in PCx group, while the D2-immunized birds had significantly lower lesion scores when compared to PCx. Gene expression analysis revealed that PCx birds had significantly higher expression of pro-inflammatory cytokine genes in the skin, muscle and spleen than the NCx group, while the D2 group had significantly lower expression of these genes compared to PCx. Peripheral blood cellular analysis showed increased frequencies of activated CD4+ and/or CD8+ cells in the D1 and D2-immunized groups. Additionally, the immunized turkeys developed antigen-specific serum IgY antibodies. Collectively, these findings indicate that ntATX proteins, specifically the ntATX-D2 can be a promising vaccine candidate for protecting turkeys against CD and that the protection mechanisms may include downregulation of C. septicum-induced inflammation and increased CD4+ and CD8+ cellular activation.

Impacto de la implementación de la estrategia multimodal de la OMS para mejorar la higiene de manos en una Unidad de Cuidados Intensivos / Impact on implementation of multimodal of World Health Organization strategies to improve hand hygiene in an Intensive Care Unit

INTRODUCCIÓN: La higiene de manos (HM) es la principal medida para disminuir las IAAS, las que en las Unidades de Cuidados Intensivos (UCI) presentan una alta prevalencia. En Chile no existe información sobre el impacto de la estrategia multimodal de la OMS para la HM en adultos. El objetivo fue evaluar el impacto de la implementación de la estrategia en una UPC. METODOLOGÍA: Estudio longitudinal con evaluación pre y post-intervención, entre los años 2018 y 2021, en la UCI del Hospital del Trabajador (HT), Santiago, Chile. La implementación se evaluó con pautas de cumplimiento de HM, consumo de jabón y productos en base alcohólica (PBA). El impacto se midió con las tasas de neumonía asociada a ventilación mecánica (NAVM), infecciones del torrente sanguíneo asociadas a CVC (ITS- CVC) y del tracto urinario por CUP (ITU-CUP), y la incidencia anual de dermatitis. RESULTADOS: El cumplimiento de pautas aumentó de 91 a 96% (p < 0,05). El consumo total de productos para la HM aumentó de 0,17 a 0,31 L/día/cama y de PBA en 10%. Las tasas de IAAS pre y post-intervención fueron para NAVM de 10,3 y 8,4; ITS-CVC de 0,8 y 1,5 e ITU-CUP de 4,2 y 5,3 por 1.000 días de exposición. La incidencia anual de dermatitis disminuyó en 30% (p < 0,05). CONCLUSIONES: La implementación de la estrategia multimodal se asoció a una disminución de las tasas de NAVM y de dermatitis en la UCI del HT.

INTRODUCTION: Hand hygiene is the main measure to decrease infections related to healthcare and the Intensive Care Unit has a high prevalence. In Chile there aren't reports about the impact of the World Health Organization multimodal hand hygiene improvement strategy. AIM: To assess the implementation impact of this strategy at the ICU. METHODOLOGY: Longitudinal study with pre- and postintervention evaluation during the years 2018-2021 at ICU. The implementation was assessed against hand hygiene compliance guidelines, soap consumption and alcohol-based products. The impact was evaluated with the rates of ventilator-associated pneumonia (VAP), catheter related bloodstream infection (CRBSI) and catheter associated urinary tract infection (CAUTI) and the annual dermatitis incidence. RESULTS: The guidelines compliance increased from 91% to 96% (p < 0.05). The total product consumption increased from 0.17 to 0.31 Liters/day/bed. The use of alcohol-based products increased by 10%. HAI rates pre- and post-intervention were for VAP 10.3 and 8.4, CRBSI 0.8 and 1.5 and CAUTI 4.2 and 5.3. The annual dermatitis incidence decreased by 30.8% (p < 0.05). CONCLUSIONS: The strategy implementation benefited the decrease of VAP and the dermatitis prevention in ICU.

Prolyl hydroxylase inhibition protects against murine MC903-induced skin inflammation by downregulating TSLP.

Previously, we reported an anti-inflammatory effect of mTORC1 in a mouse model of type 2 skin inflammation. TSLP, one of the epithelial cell-derived cytokines, was upregulated by Raptor deficiency or rapamycin treatment, which was inhibited by dimethyloxalylglycine (DMOG). However, it remains unclear how DMOG regulates TSLP expression and type 2 skin inflammation. In this study, we investigated the protective effect of DMOG on MC903 (calcipotriol)-induced type 2 skin inflammation. Morphological and immunological changes were assessed by H-E staining, flow cytometry and RT-qPCR. DMOG treatment attenuated MC903-induced skin inflammation in a T cell-independent manner. The anti-inflammatory effect of DMOG was accompanied by downregulation of TSLP and IL-33, and supplementation with recombinant TSLP and IL-33 abolished the effect of DMOG. MC903 increased ROS levels in skin tissue, which was prevented by DMOG. Furthermore, the ROS scavenger N-acetylcysteine (NAC) downregulated TSLP and ameliorated MC903-induced skin inflammation, as did DMOG. Finally, the effect of DMOG on ROS and TSLP was reduced by HIF knockdown. These results suggest that DMOG downregulates TSLP and ROS through the HIF pathway, which reduces MC903-induced skin inflammation.

Intervenção especializada de enfermagem na prevenção, avaliação e tratamento da dermatite associada à incontinência na pessoa idosa / Specialized nursing intervention in the prevention, evaluation and treatment of dermatitis associated with incontinence in the elderly

A dimensão das dermatites associadas à incontinência é desconhecida em diversos contextos de prestação de cuidados, principalmente em Portugal. Contudo sabe-se que afeta uma elevada percentagem de pessoas idosas, não só pelo processo de envelhecimento da pele, mas também por ser comum apresentarem incontinência urinária e fecal. Um dos principais focos da enfermagem é a integridade da pele, e por isso é importante atentar nos principais fatores de risco para o desenvolvimento de lesões na mesma, e consequentemente desenvolvimento de dermatite associada à incontinência. O presente relatório, concretiza a implementação de um projeto sustentado na metodologia de projeto, realizado na prática clínica do Curso de Mestrado em Enfermagem na Área de Especialização Enfermagem Médico-Cirúrgica na Área de Intervenção à Pessoa Idosa, em dois contextos distintos, uma unidade de cuidados na comunidade e um serviço de internamento hospitalar. A realização do estágio e implementação do projeto permitiu-nos desenvolver competências ao nível de atividades centradas numa prática baseada na evidência, tendo por base os resultados de uma revisão integrativa da literatura; nomeadamente no envolvimento da pessoa idosa e sua família no plano de cuidados, centrado na prevenção da dermatite associada à incontinência; sensibilizamos ainda as equipas de cuidados para a temática; implementamos intervenções e estratégias para a prevenção da dermatite associada à incontinência e desenvolvemos um guia orientador para a prática de cuidados. Percebemos também que um plano de cuidados de enfermagem individualizado permite a implementação de intervenções adequadas, através da realização de um diagnóstico diferencial eficaz, incluindo procedimentos preventivos e tratamentos apropriados em pessoas idosas com situações de dermatite. Este percurso possibilitou a aquisição e desenvolvimento de competências inerentes ao grau de mestre e enfermeiro especialista em enfermagem médico-cirúrgica, no cuidado à pessoa idosa e família.

The dimension of incontinence-associated dermatitis is unknown in several contexts of care provision, mainly in Portugal. However, it is known that it affects a high percentage of elderly-people, not only because of the skin aging process but also because it is common to have both urinary and fecal incontinence. One of the main focuses in nursing is skin integrity. Hence the importance to be aware of the main risk factors for developing skin damage and, consequently, the development of incontinence-associated dermatitis. Therefore, an evidence-based practical approach, supported by the literature review, centered on the prevention of incontinence-associated dermatitis and sensitization of health teams in the subject achieved by implementing strategies for preventing incontinence-associated dermatitis and developing guidelines for the care practice. Furthermore, we also realized that an individualized nursing care plan allows for the implementation of adequate interventions, by performing an effective differential diagnosis, including preventive procedures and appropriate treatments in elderly people with situations of dermatitis. The path taken led to the acquisition and further development of skills inherent to the master's degree and specialized nurse in medical-surgical nursing, in elderly care and family.

Uso de terapêutica homeopática em dermatites recorrentes na rotina clínica de animais de companhia: uma revisão / use of homeopathic therapeutics in recurrent dermatitis in the clinical routine of companion animals: a review

Na clínica veterinária as patologias chamadas afecções dermatológicas representam uma porcentagem significativa dos atendimentos, podendo ser de cunho multifatorial ou unifatorial como infecciosa, alérgena ou psicogênica e acometem felinos e caninos de todas as idades. Comumente os medicamentos homeopáticos são usados como último recurso após insucessos consecutivos com a utilização da terapia alopática. Desta forma, esse artigo visa trazer uma revisão bibliográfica de trabalhos científicos que confirmam a eficácia de terapêuticas que utilizam intervenções homeopáticas para o tratamento de dermatites em animais de companhia. Tem-se, portanto, o intuito de propiciar uma maior divulgação das possibilidades de ação/utilização da homeopatia pela comunidade médica veterinária, evitando-se com isso possíveis efeitos adversos devido à utilização de medicações alopáticas.

In the veterinary clinic, the pathologies called dermatological illnesses represent a significant percentage of the consultations, being of a multifactorial or unifactorial nature such as infectious, allergenic or psychogenic and affect felines and canines of all ages. Homeopathic medicines are commonly used as a last resort after consecutive failures with the use of alopathic therapy. Thus this article aims to bring a bibliographic review of scientific papers that confirm the efficacy of therapies that use homeopathic interventions for the treatment of dermatitis in company animals. Therefore it is intended to provide a greater dissemination of the possibilities of action/use of homeopathy by the veterinary medical community thereby avoiding possible adverse effects due to the use of alopathic medications.

A new APP for prevention and treatment of complications of intestinal peristomal skin / Aplicativo para prevenção e tratamento das complicações da pele periestoma intestinal

ABSTRACT Objectives To develop an application program for prevention and treatment of complications of intestinal peristomal skin. Method The framework of the application software development were: Phase 1 - "Design, identification of the needs for the application development": In this phase, the authors identified during their clinical practice that some professionals and caregivers find it difficult to provide care for at-risk ostomized patients or those with some kind of peristomal skin complication; Phase 2 - "Application prototype development": this phase included the integrative literature review in the main databases; Phase 3 - "Creating the application": this phase was intended to generate a decision tree algorithms, structure the database, and develop the software; Phase 4 - "Transition": performing the application functionality testing. Results The application "Dermatite Periestoma App" has 36 screens and 21 figures describing the procedures for prevention and treatment of complications of intestinal peristomal skin. It is freely available from the Play Store and has been registered with the Instituto Nacional da Propriedade Industrial Ministério do Desenvolvimento, indústria e Comércio Exterior (Brazilian Ministry of Development, Industry and Foreign Trade, National Institute of Industrial Property). Conclusion This study made it possible to describe the stages of planning and development of the mobile application "Dermatite Periestoma App". The steps taken indicate that the "Dermatite Periestoma App" has great potential for clinical practice in the evaluation of patients with stomal complications or at risk for developing peristomal skin complications, preventive measures, therapeutic approaches, and for nursing education through the use of technology.

RESUMO Objetivos Desenvolver um aplicativo para prevenção e tratamento de complicações da pele periestoma intestinal. Método As fases de desenvolvimento da estrutura do aplicativo foram: Fase 1 - "Concepção, identificação das necessidades do desenvolvimento do aplicativo": nessa fase os autores identificaram, durante sua prática clínica, que alguns profissionais e cuidadores têm dificuldade em prestar assistência aos ostomizados com risco ou que adquirirem algum tipo de complicação da pele periestoma; Fase 2 - "Elaboração do protótipo do aplicativo": essa fase contemplou a revisão integrativa da literatura nas principais bases de dados; Fase 3 - "Construção do aplicativo": essa fase consistiu na elaboração da árvore de decisão dos algoritmos, estruturação do banco de dados e desenvolvimento do software; Fase 4 - "Transição": foram realizados os testes de funcionalidade do aplicativo. Resultados O aplicativo "Dermatite Periestoma App" tem 36 telas e 21 figuras descrevendo os procedimentos para prevenção e tratamento das complicações da pele periestoma intestinal. O mesmo está disponível gratuitamente naPlay Store e foi registrado no Instituto Nacional da Propriedade Industrial Ministério do Desenvolvimento, indústria e Comércio Exterior. Conclusão Este estudo possibilitou descrever as etapas do planejamento e desenvolvimento do aplicativo móvel "Dermatite Periestoma App". As etapas percorridas indicam que o "Dermatite Periestoma App" tem grande utilidade potencial para a prática clínica na avaliação do ostomizado com complicação ou que apresenta risco para desenvolver complicações da pele periestoma, medidas preventivas, condutas terapêuticas, e para o ensino de Enfermagem por meio do uso de tecnologia.

Aplicativo "SICKSEG" em plataforma móvel para a prevenção de lesões cutáneas / App "SICKSEG" in mobile platform to prevention of skin injuries

Objetivo: desenvolver um aplicativo para auxiliar o profissional da saúde na prescrição de medidas preventivas aos indivíduos em risco de desenvolver lesões cutâneas. Método: trata-se de um estudo bibliográfico, descritivo, tipo revisão integrativa da literatura, sem limite temporal, com busca na MEDLINE, LILACS, COCHRANE e Biblioteca Virtual SciELO. Revela-se que as etapas de desenvolvimento da estrutura do aplicativo foram: "Análise", para a construção do fluxograma do aplicativo; "Design" - para o planejamento e a produção do conteúdo didático; "Desenvolvimento" ­ para a seleção das ferramentas do aplicativo, e "Implementação" ­ em que foram realizados os testes de funcionalidade do aplicativo. Resultados: compõe-se o aplicativo SickSeg por 100 telas e está disponível gratuitamente no Play Store. Realizaram-se os testes de funcionalidade em dois tipos de notebook, seis tipos smartphone e dois tipos de tablet. Identificaram-se, durante os testes, cinco problemas no funcionamento do aplicativo, os quais foram sanados. Conclusão: desenvolveu-se o aplicativo que tem o potencial de auxiliar na prevenção de lesões cutâneas por meio da indicação de medidas preventivas, proporcionando segurança para o paciente.(AU)

Objective: to creat an app to aid the health professional in prescribing preventive measures to individuals at risk of developing skin Injuries. Method: this is a bibliographic, descriptive study, type integrative literature review, with no time limit, with search on MEDLINE, LILACS, COCHRANE and SciELO Virtual Library. Inquires that the stages for creating the app structure were: "Analysis", for creating the app flowchart; "Design" - for the planning and production of didactic content; "Developing" - for selecting of the app tools, in which the functionality tests were performed. Results: the SickSeg app is made up of 100 screens and is available for free on the Play Store. Functionality tests were performed on two types of notebook, six types smartphone and two types of tablet. During the tests, five problems in the operation of the app were identified, which were remedied. Conclusion: the app has been created which has the potential to aid prevent skin injuries through the indication of preventive measures, providing safety for the patient.(AU)

Objetivo: desarrollar una aplicación para ayudar al profesional de la salud a prescribir medidas preventivas a las personas en riesgo de desarrollar lesiones cutáneas. Método: es un estudio bibliográfico, descriptivo, tipo revisión bibliográfica integradora, sin límite de tiempo, con búsqueda en MEDLINE, LILACS, COCHRANE y la Biblioteca Virtual SciELO. Se revela que las etapas de desarrollo de la estructura de la aplicación fueron: "Análisis", para la construcción del diagrama de flujo de la aplicación; "Diseño" - para la planificación y producción de contenido didáctico; "Desarrollo" - para la selección de herramientas de aplicación e "Implementación" - donde se llevaron a cabo las pruebas de funcionalidad de la aplicación. Resultados: la aplicación SickSeg consta de 100 pantallas y está disponible de forma gratuita en Play Store. Las pruebas de funcionalidad se llevaron a cabo en dos tipos de notebook, seis tipos de smartphone y dos tipos de tablet. Durante las pruebas, se identificaron cinco problemas en el funcionamiento de la aplicación, que se solucionaron. Conclusión: se desarrolló la aplicación, que tiene el potencial de ayudar a prevenir lesiones cutáneas a través de la indicación de medidas preventivas, brindando seguridad al paciente.(AU)

Complicações de estomia intestinal e pele periestoma: evidências para o cuidado de enfermagem / Complications of ostomy bowel and peristomal skin: evidence for nursing care / Complicaciones de la ostomía intestinal y de la piel peristoma: evidencia para el cuidado de enfermeira

Objetivo: identificar e analisar as evidências disponíveis na literatura sobre as complicações de estomia intestinal e pele periestoma. Método: revisão integrativa, em bases virtuais de dados, com inclusão de estudos do tipo ensaio clínico randomizado, publicados nos idiomas inglês, espanhol e português, no período de maio 2013 a maio de 2019. Resultados: foram selecionados 19 estudos e agrupados em três categorias: técnicas cirúrgicas apontando técnicas inovadoras acerca do tipo de suturas, ressecção e exteriorização de alça intestinal, além de reforços para prevenção de hérnias; barreiras de pele e equipamentos coletores, abordando principalmente as barreiras de pele para prevenção e tratamento da dermatite; cuidados de enfermagem mostrando cuidados e programas de acompanhamento, como visitas domiciliares, consultas e programas educativos. Conclusões: As estratégias descritas nos estudos revisados são importantes na medida em que poderão enriquecer o conhecimento do enfermeiro e dessa forma reduzir complicações de estomia e pele periestoma e melhorar a qualidade de vida dessas pessoas.

Objective: to identify and analyze the evidence available in the literature on the complications of intestinal ostomy and peristomal skin. Method: integrative review in virtual databases, including randomized clinical trialstudies published in English, Spanish and Portuguese, from May 2013 to May 2019. Results: 19 studies were selected and grouped into three categories: surgical techniques pointing innovative techniques about the type of sutures, resection and externalization of the intestinal loop, in addition to reinforcements to prevent hernias; skin barriers and collecting equipment, mainly addressing skin barriers for the prevention and treatment of dermatitis; nursing care showing care and follow-up programs such as home visits, consultations, and educational programs. Conclusion: the strategies described in the reviewed studies are important as they may enrich the knowledge of nurses and thus reduce complications of ostomy and peristome skin and improve the quality of life of these people.

Objetivo: identificar y analizar la evidencia disponible en la literatura sobre las complicaciones de la ostomía intestinal y la piel peristomal. Método: revisión integradora en bases de datos virtuales, incluidos estudios de ensayos clínicos aleatorizados publicados en inglés, español y portugués, de mayo de 2013 a mayo de 2019. Resultados: se seleccionaron 19 estudios y se agruparon en tres categorías: técnicas quirúrgicas que apuntan técnicas innovadoras sobre el tipo de suturas, resección y externalización del asa intestinal, además de refuerzos para prevenir hernias; barreras cutáneas y equipos de recolección, principalmente para abordar las barreras cutáneas para la prevención y el tratamiento de la dermatitis; atención de enfermería que muestra programas de atención y seguimiento, como visitas domiciliarias, consultas y programas educativos. Conclusiones: Las estrategias descritas en los estudios revisados on importantes ya que pueden enriquecer el conocimiento de las enfermeras y, por lo tanto, reducir las complicaciones de la ostomía y la piel peristómica y mejorar la calidad de vida de estas personas.

Efectividad de la película transparente de polímero de acrilato en la prevención y tratamiento de lesiones de la piel. Revisión bibliográfica / Effectiveness of transparent acrylate polymer film in the prevention and treatment of skin lesions. Bibliographic review

Objetivos: Obtener evidencias disponibles sobre la eficacia de la película transparente de polímero de acrilato o producto barrera no irritante (PBNI) en la prevención y tratamiento de lesiones de la piel. Método: Revisión de la literatura a partir de la búsqueda de ensayos clínicos aleatorizados y estudios observacionales sobre los PBNI en PubMed, CINAHL y CUIDEN, publicados entre 2009 y 2018, ya que existe una revisión sistemática anterior. Resultados: Dos estudios evidenciaron reducción de complicaciones cutáneas aplicando PBNI antes de la colocación de apósitos de sujeción para catéteres venosos centrales. Respecto a las complicaciones cutáneas de la radioterapia, un estudio observó que los PBNI solo ayudaban a retrasar la intensidad del prurito. Un trabajo sobre la prevención y tratamiento de la dermatitis por incontinencia constataba que los PBNI son una buena alternativa a las cremas barrera, ya que tienen mejor aceptabilidad y cuestan menos de aplicar y retirar. En el ámbito del exceso de exudado y sus complicaciones en la zona periulceral, dos estudios coincidieron en la efectividad de los PBNI para reducir el diámetro de la superficie, exudado y esfacelo. Conclusiones: Los PBNI ayudan a prevenir las lesiones de la piel provocadas por apósitos de catéter; en la radiodermitis solo ayudan a disminuir el prurito; en las dermatitis por incontinencia son alternativa a la cremas barrera; en el control de las complicaciones del exudado en la zona periulceral en lesiones de extremidad inferior son igual de efectivos que las cremas con zinc

Objectives: To obtain available evidence on the efficacy of transparent film of acrylate polymer or non-irritating barrier product (PBNI) in the prevention and treatment of skin lesions. Method: Review of the literature based on the search of randomized clinical trials and observational studies on PBNI in PubMed, CINAHL and CUIDEN published between 2009 and 2018, since there is a previous systematic review. Results: Two studies showed reduction of cutaneous complications by applying PBNI before the placement of fixation dressings for central venous catheters. Regarding the cutaneous complications of radiotherapy, one study observed that PBNI only helped to delay the intensity of pruritus. A work on the prevention and treatment of incontinence dermatitis found that PBNI are a good alternative to barrier creams, since they have better acceptability and cost less to apply and remove. In the area of excess exudate and its complications in the periulceral zone, two studies agreed on the effectiveness of PBNI to reduce the diameter of the surface, exudate and slough. Conclusions: PBNI helps to prevent skin lesions caused by catheter dressings, in radiodermatitis they only help to reduce pruritus, in incontinence dermatitis they are an alternative to barrier creams, in the control of the complications of exudate in the periulceral zone in lower limb injuries are just as effective as creams with zinc

Estrategias de enfermería para prevenir lesiones de piel en personas con riesgo de padecerlas / Nursing strategies to prevent skin lesions in people at risk of suffering

RESUMEN Introducción: las lesiones de piel asociadas al cuidado representan fallas en la seguridad del paciente que generan altos costos económicos e impactos emocionales. A pesar de los esfuerzos de las organizaciones de salud a nivel mundial para disminuir su incidencia y prevalencia, estas lesiones continúan siendo un problema común de la atención en salud, por lo tanto es necesario identificar y establecer las mejores estrategias para su prevención. Objetivo: describir estrategias efectivas de enfermería para la prevención de lesiones de piel en personas que están en riesgo de padecerlas. Métodos: revisión sistemática de la producción científica disponible en los años 2005-2015 en las bases de datos Medline, Science Direct, FECYT, Embase, Ovid Nursing, Scielo y Cuiden. La evaluación de los artículos se realizó con el instrumento GRADE. Conclusiones: las estrategias se estructuraron a partir de elementos fundamentales como: diagnóstico previo, uso de escalas de valoración del riesgo, uso de diferentes tecnologías de la información, herramientas educativas adaptadas a las necesidades identificadas y enseñanza práctica, auditoría permanente que garantice el cumplimiento y actualización constante. Las estrategias efectivas para prevenir lesiones de piel deben enfocarse acorde a las necesidades identificadas en los pacientes y mantenerse en el tiempo para identificar oportunamente los factores que las generan. Se debe reconocer la existencia de otras lesiones como la dermatitis asociada a la incontinencia y lesiones por iatrogenia como posibles causas que originan lesiones más graves afectando la seguridad del paciente, a fin de que su prevención sea más efectiva(AU)

ABSTRACT Introduction: Skin lesions associated with caring represent failures in patient safety that generates high economic and emotional impacts costs. Despite the efforts of health organizations worldwide to reduce its incidence and prevalence, these injuries remain a common problem in health care, so it is necessary to identify and establish the best strategies for prevention. Objective: Describe the effective nursing strategies for the prevention of skin lesions in people who are at risk of suffering. Methods: Systematic review of the available scientific production in the years 2005-2015 in Medline, Science Direct, FECYT, Embase, Ovid Nursing, Scielo and care. Articles assessment was performed with the GRADE instrument. Conclusions: The strategies were structured from key elements such as: previous diagnosis, use of risk assessment scales, using different information technologies, educational tools adapted to the needs identified and practical teaching, continuous auditing to ensure compliance and constant updating. Effective strategies to prevent skin lesions should focus according to needs identified in patients and maintained over time to quickly identify the factors that generate them. It must recognize the existence of other lesions as incontinence associated dermatitis and iatrogenic lesions as potential causes of more severe lesions affecting patient safety, so that prevention either more effective(AU)

Diretrizes de cuidado na prevenção da dermatite periestomal em clientes oncológicos: proposta educativa compartilhada com enfermeiros

Tratou-se da construção de diretrizes para elaboração de um plano de cuidados ao clienteoncológico recém-estomizado visando à prevenção da dermatite periestomal, tendo comoobjetivos: descrever saberes e práticas de enfermeiros sobre os cuidados básicos à prevençãoda dermatite periestomal em clientes oncológicos recém-estomizados; construir diretrizes paraelaboração de um plano de cuidados de enfermagem voltados à prevenção da dermatiteperiestomal nesses clientes; implementar e avaliar o plano de cuidados junto aos enfermeiros.Pesquisa de campo qualitativa, emprego do Método Convergente-Assistencial, aprovada pelosComitês de Ética em Pesquisa do campo do estudo e da Escola de Enfermagem Anna NeryHospitalEscola São Francisco de Assis. Desenvolvida em quatro enfermarias cirúrgicas de umhospital público oncológico da cidade do Rio de Janeiro, com a participação de dezoitoenfermeiros. Os dados foram produzidos através de entrevista individual semiestruturada;técnica de criatividade e sensibilidade Corpo-Saber; discussão nos grupos de convergência; eobservação participante. Aplicada análise de conteúdo temática. A matriz pedagógicaproblematizadora, de orientação dialogada, subsidiou a discussão com os enfermeiros naconstrução das diretrizes, implementação e avaliação do plano de cuidados, considerando odesenvolvimento da consciência crítica e autônoma dos clientes no cuidado de si. Os resultadosrevelaram experiências dos participantes sustentadas no conhecimento científico e habilidadestécnicas adquiridas durante sua trajetória profissional...

This was the guidelines elaboration of a care plan to recent ostomized cancer patientaiming to prevent peristomal dermatitis, having as purposes: to describe nurses´ knowledgeand practices about basic care in the prevention of peristomal dermatitis in recent ostomizedcancer patient; to build guidelines for elaboration of a nursing care plan with respect to theprevention of the peristomal dermatitis in these clients; to implement and evaluate the care plantogether with the nurses. Qualitative field research which used the Convergent-AssistentialMethodology, approved by the Research Ethics Committee of the study field and of the AnnaNery School of Nursing- St. Francis of Assis Teaching Hospital. Developed in four surgicalnurseries of an oncological public hospital of the Rio de Janeiro city, with the participation ofeighteen nurses. The data were collected using semi-structured individual interview; Dynamicsof Creativity and Sensitivity Body knowledge; discussion convergence groups; and participantobservation. Applied thematic content analysis.The Problem-Dialogical Matrix fostered thediscussion with the nurses in the elaboration of the guidelines, implementation and evaluationof the care plan, considering the development of the critical and autonomous conscientiousnessof the clients in the Self Care. The findings revealed participants’ experiences supported byscientific knowledge and technical abilities acquired during its professional trajectory...

Se trató de la construcción de directrices para elaboración de un plan de cuidados alcliente oncológico recién ostomizado visando a la prevención de la dermatitis periestomal,teniendo como objetivos: describir saberes y prácticas de enfermeros sobre los cuidados básicosa la prevención de la dermatitis periestomal en clientes oncológicos recién estomizados;construir directrices para elaboración de un plan de cuidados de enfermería dirigidos a laprevención de la dermatitis periestomal en eses clientes; implementar y evaluar el plan decuidados junto a los enfermeros. Pesquisa de campo cualitativa, empleo del MétodoConvergente Asistencial, aprobada por los Comités de Ética en Pesquisa del campo del estudioy de la Escuela de Enfermería Anna Nery-Hospital Escuela São Francisco de Assis.Desarrollada en cuatro enfermerías quirúrgicas de un hospital público oncológico de la ciudaddel Rio de Janeiro, con la participación de dieciocho enfermeros. Los datos fueron producidosa través de entrevista individual semiestructurada; técnica de creatividad y sensibilidad CuerpoSaber;discusión en los grupos de convergencia; y observación participante. Aplicada análisisde contenido temático. La matriz pedagógica problematizadora, de orientación dialogada,subsidió la discusión con los enfermeros en la construcción de las directrices, implementacióny evaluación del plan de cuidados, considerando el desarrollo de la consciencia crítica yautónoma de los clientes en el cuidado de sí. Los resultados revelaron experiencias de losparticipantes sustentadas en el conocimiento científico y habilidades técnicas adquiridasdurante suya trayectoria profesional...

Dermatite associada à incontinência: estudo de coorte em pacientes críticos / Incontinence-associated dermatitis: a cohort study in critically ill patients

A Unidade de Terapia Intensiva (UTI) é o local destinado ao atendimento de pacientes graves e durante a internação esses estão expostos a diversos fatores que podem levar a ocorrência de danos na pele. Dentre esses danos, a dermatite associada à incontinência (DAI). O objetivo geral do estudo é analisar o problema da DAI em pacientes adultos internados em uma UTI de um hospital público de Belo Horizonte - MG. Já os objetivos principais foram:identificar na literatura os fatores de risco para DAI em pacientes adultos,caracterizar os pacientes que desenvolveram a DAI, estimar a incidência,determinar os fatores de risco de DAI na UTI e propor um modelo de predição de risco. Trata-se de um estudo realizado em três etapas: revisão integrativa(RI), grau de concordância e estudo de coorte concorrente. Os fatores de risco para DAI identificados na RI foram: idade, comorbidades, nutrição, oxigenação,perfusão, temperatura, incontinência fecal e/ou urinária, atrito mecânico, uso agentes irritantes, capacidade cognitiva. Obteve-se uma incidência global de20,4% e uma densidade de incidência de 2,5 casos/100 pessoas -dia. Foram encontrados 19 fatores de risco que apresentaram associação significativa coma DAI. No modelo final de predição de risco encontrou-se: sexo masculino,trauma, hipnótico/sedativos, lactulona, suporte nutricional, fezes pastosas e ardência. Os resultados mostraram que a DAI é um achado comum em pacientes internados em UTI adulto e por isso merece atenção especial para que se tenha melhoria na qualidade da assistência de enfermagem prestada a esses pacientes.

The Intensive Care Unit (ICU) is the place for the care of critically ill patients during hospitalization and these are exposed to several factors that can lead to damage to the skin. Among such damage, dermatitis associated with incontinence (DAI). The overall objective of the study is to analyze the problemof DAI in adult patients admitted to the ICU of a public hospital in Belo Horizonte- MG. Since the main objectives were to identify the literature the risk factors forDAI in adult patients, to characterize patients who developed DAI estimate theincidence, determine the DAI risk factors in ICU and propose a risk prediction model. This is a study carried out in three stages: an integrative review (RI),degree of concordance and study concurrent cohort. The risk factors identifiedin DAI RI were age, comorbidities, nutrition, oxygenation, perfusion,temperature, fecal and / or urinary incontinence, mechanical friction, use irritants, cognitive ability. This yields an overall incidence of 20.4% and an incidence density of 2.5 cases / 100 person-days. They found 19 risk factors significantly associated with DAI. In the final model of risk prediction met: male,trauma, hypnotic / sedative, lactulona, nutritional support, loose stools and burning. The results showed that the DAI is a common finding in patients admitted to adult ICUs and therefore deserves special attention in order to have better quality of nursing care provided to these patients.

Quality of sleep in allergic children and their parents

BACKGROUND: Quality of sleep is essential for physical and mental health and influences the perception of the patient's well-being during the day. In patients with chronic allergic diseases sleep disorders may increase the severity of the condition, complicate the management and impair their quality of life. When children are concerned, their parents are also affected by the problem. We evaluated the presence of disrupted sleep in parents of children with atopic disorders, and its relationship with clinical features and the presence of disturbed sleep in children. METHODS: Parents of children suffering from allergic diseases were recruited from the Pediatric Allergy Units of Parma University. Evaluation of sleep in parents was based on the Pittsburg Sleep Quality Index (PSQI), while in children it was based on the Sleep Disturbance Scale for Children (SDSC). RESULTS: Of the 102 parents invited, 92 filled in the questionnaire. Only the questionnaires with more than a 95% completion rate were considered for analysis. PSQI mean score in parents was 6.6 (SD 2.6); 75.6% of them had a PSQI ≥ 5, indicating that most parents had a sleep quality perceived as bad. The PSQI ≥ 5 was more common in parents of children with asthma and rhinitis. In children, SDSC mean score was 42.1 (SD: 9.4); 62.3% had a total score ≥ 39. The quality of sleep in parents and children was significantly correlated (p < 0.001). CONCLUSION: These findings make it apparent that an alteration of sleep in children can also affect the parents. Such effect further weighs the burden of respiratory allergy and needs to be considered in future studies

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Lesiones por humedad. Revisión de conocimientos / Moisture lesions. A review

La dermatitis asociada a la incontinencia, una manifestación clínica de lesiones de la piel asociadas a la humedad, es un estado caracterizado por irritación e inflamación, y es una consideración común en pacientes con incontinencia urinaria y/o fecal. Debido a la localización y apariencia de estas 'lesiones por humedad', a menudo se confunden con las úlceras por presión. Objetivo: Llevar a cabo una revisión bibliográfica acerca del término 'lesiones por humedad'. Método: Se realizó una búsqueda de datos mediante el metabuscador Gerion del Sistema Sanitario Público de Andalucía. El término empleado para la búsqueda fue el concepto 'lesiones por humedad' en inglés ('moisture lesions'). La recolección de datos fue realizada por una sola persona. Se identificaron y analizaron 18 artículos en los que se trata el concepto 'lesiones por humedad'. Resultados y conclusiones: El diagnóstico diferencial, usualmente basado en el examen visual, puede ayudar a determinar si está presente una úlcera por presión o una lesión por humedad. Los objetivos del tratamiento incluyen proteger la piel de un daño adicional por la exposición a irritantes y establecer un ambiente orientado a la curación. Esta revisión de la literatura subraya la escasa cantidad de información basada en la evidencia disponible y destaca la necesidad de realizar más estudios. Esto debería alentar a las enfermeras a prestar más atención a las lesiones por humedad y a su evaluación y tratamiento (AU)

Incontinence-associated dermatitis, a clinical manifestation of moisture-associated skin damage, is a condition characterized by irritation and inflammation, and is a common consideration in patients with fecal and/or urinary incontinence. Due to the location and appearance of 'moisture lesions', they are often mistaken for pressure ulcers. Objective: To perform a literature review about the term 'moisture lesions'. Methods: We conducted a search of data through the metasearch Gerion Andalusian Public Health System. The term used for search centered on the concept: 'moisture lesions'. Data extraction was performed by a single person. We identified and analyzed 18 articles in which the term 'moisture lesions' is treated. Results and conclusions: Differential diagnosis, usually based on visual examination, can help determine whether incontinence-associated dermatitis or a pressure ulcer is present.Treatment goals include protection of the skin from further exposure to irritants and establishment of a healing environment. This review of literature underscores the scant amount of evidence-based information available and highlights the need for further studies. This should encourage nurses to pay closer attention to moisture lesions and its assessment and treatment (AU)

Knowledge of undergraduate nursing course teachers on the prevention and care of peristomal skin / Conhecimentos dos docentes do curso de graduação em enfermagem sobre prevenção e cuidados com a pele periestoma

Objective: To evaluate the knowledge of undergraduate nursing course teachers on peristomal skin care in individuals with intestinal stoma. Methods: This is an exploratory, analytical and cross-sectional study, conducted with undergraduate nursing course teachers from two private universities in the city of São Paulo, named A and B. The sample consisted of 42 teachers/nurses, being 22 from University A and 20 from University B, who supervised the internship at Hospital Vila Nova Cachoeir-inha. With the aim to collect data, a structured questionnaire consisting of 10 questions (checklist) was used; each question in the checklist had correct and wrong answers. The teachers had to indicate with "x" the correct answer. The questionnaire was delivered to teachers/nurses on a predetermined day. Data collection was carried out on August 2006. Results: The majority of study participants know that stoma demarcation must be performed preoperatively, and that it is important to educate the patient about surgery, care for the stoma and on the collecting device, as well as to perform a sensitivity test for the equipment. The hygiene should be performed with mild soap and water and with a piece of clean, soft, damp cotton cloth without rubbing, and the skin must be kept dry. The hair removal should be done with curved tip scissors, cutting close to the abdominal wall. Conclusion: The results showed that, although most of the participants have a basic knowledge about stomized patients care, updating and improvement are needed. (AU)

Objetivo: Avaliar o conhecimento de docentes do curso de graduação em enfermagem sobre os cuidados com da pele periestomal nos indivíduos com estomas intestinais. Métodos: Trata-se de um estudo exploratório, analítico e transversal realizado com os docentes dos Cursos de Graduação em Enfermagem de duas Universidades privadas da cidade de São Paulo, denominadas A e B. A amostra foi constituída de 42 docentes/enfermeiros, sendo 22 da Universidade A e 20 da Universidade B, que supervisionavam estágio no Hospital Vila Nova Cachoeirinha. Para a coleta de dados, foi utilizado questionário estruturado, composto de 10 questões (check list); cada questão do check list tinha respostas corretas e erradas. Os docentes tinham de assinalar com x a resposta correta. O questionário foi entregue aos docentes/enfermeiros em dia pré-determinado. A coleta de dados foi realizada em agosto de 2006. Resultado: A maioria dos participantes do estudo sabe que a demarcação do estoma deve ser realizada na fase pré-operatória e que é importante orientar o paciente quanto ao ato operatório, aos cuidados com o estoma, equipamentos coletores e realização do teste de sensibilidade aos equipamentos. A higiene deve ser feita com água e sabão neutro e com um pedaço de tecido de algodão limpo, macio e úmido, sem esfregar; a pele deve ser mantida seca. A remoção de pêlos deve ser feita com tesoura de ponta curva, cortando rente à parede do abdômen. Conclusão: Os resultados revelaram que apesar da maioria dos participantes possuir conhecimentos básicos sobre o cuidado da pessoa estomizada, há necessidade de atualização e aprimoramento. (AU)