A multidisciplinary approach to incontinence-associated dermatitis in a rural setting: a case study

Abstract

Incontinence-associated dermatitis (IAD) is a common complication often unrecognised and mistreated in individuals with incontinence. It is the erosion of the skin from prolonged exposure to urine and/or faeces from incontinence and is often mistaken for a pressure injury. People experience considerable discomfort such as pain, burning and itching in the affected areas (buttocks, perineum and gluteal clefts). The prevention and management of IAD involves assessing and managing incontinence and implementing a skin care regimen to protect and maintain the integrity of the person’s skin. We report a case study of a 71-year-old female to illustrate the benefits of an interdisciplinary plan of care for IAD to prevent further complications. The woman at the centre of our case study had multiple co-morbidities and severe urinary stress incontinence prior to her admission. A multidisciplinary team – continence nurse practitioner (NP), wound clinical nurse consultant (CNC), occupational therapist (OT) – were engaged to devise a management plan to manage her incontinence, treat the IAD and improve skin integrity. The purpose of this case study is to present their treatment journey through a regional health service, the issues encountered, and the prevention and management plans implemented in order to highlight best practices and the benefits of an interdisciplinary plan of care.