Incidence and predictors of incontinence-associated skin damage in nursing home residents with new-onset incontinence

Donna Z. Bliss, Michelle A. Mathiason, Olga Gurvich, Kay Savik, Lynn E. Eberly, Jessica Fisher, Kjerstie R. Wiltzen, Haley Akermark, Amanda Hildebrandt, Megan Jacobson, Taylor Funk, Amanda Beckman, Reed Larson

Research output: Contribution to journalArticlepeer-review

33 Scopus citations


PURPOSE: The purpose of this study was to determine the incidence and predictors of incontinence-associated dermatitis (IAD) in nursing home residents. METHODS: Records of a cohort of 10,713 elderly ( ≥ 65 years) newly incontinent nursing home residents in 448 nursing homes in 28 states free of IAD were followed up for IAD development. Potential multilevel predictors of IAD were identifi ed in 4 national datasets containing information about the characteristics of individual nursing home residents, nursing home care environment, and communities in which the nursing homes were located. A unique set of health practitioner orders provided information about IAD and the predictors of IAD prevention and pressure injuries in the extended perineal area. Analysis was based on hierarchical logistical regression. RESULTS: The incidence of IAD was 5.5%. Signifi cant predictors of IAD were not receiving preventive interventions for IAD, presence of a perineal pressure injury, having greater functional limitations in activities of daily living, more perfusion problems, and lesser cognitive defi cits. CONCLUSION: Findings highlight the importance of prevention of IAD and treatment/prevention of pressure injuries. A WOC nurse offers expertise in these interventions and can educate staff about IAD predictors, which can improve resident outcomes. Other recommendations include implementing plans of care to improve functional status, treat perfusion problems, and provide assistance with incontinence and skin care to residents with milder as well as greater cognitive defi cits.

Original languageEnglish (US)
Pages (from-to)165-171
Number of pages7
JournalJournal of Wound, Ostomy and Continence Nursing
Issue number2
StatePublished - 2017

Bibliographical note

Publisher Copyright:
Copyright © 2017 Wound, Ostomy and Continence Nurses Society™.


  • Aged
  • Dermatitis
  • Incontinence
  • Nursing homes
  • Skin
  • Skin damage .


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