Evaluating the Scales Used To Diagnose Incontinence-Associated Dermatitis: A Systematic Review.

OBJECTIVE: To investigate the scales used in the diagnosis of incontinence-associated dermatitis (IAD), including the risk factors included in the scales, their reliability and validity, and in which patient groups the scales have been applied. DATA SOURCES: The relevant studies were screened retrospectively using five MeSH (Medical Subject Headings) keywords in various combinations. Seven international databases were screened between March and July 2019. In total, 2,908 studies published between 2009 and 2019 were evaluated. STUDY SELECTION: Inclusion criteria for studies were as follows: written in English, published between 2009 and 2019, and investigated a scale developed to diagnose IAD (quantitative studies, randomized controlled studies, or meta-analyses). Studies were excluded if they did not examine scales for diagnosing IAD or were not in English. Nine studies were included in this review: five studies on scale development, one scale revision, one scale reliability study, and two Turkish validity and reliability studies. DATA EXTRACTION: The study methods, sample characteristics, interventions, validity and reliability analyses, risk factors in the scales, and subdimensions of the scales were examined for each of the nine included studies. DATA SYNTHESIS: Study samples were composed of nurses, healthcare professionals, patients, or individuals living in a nursing home and ranged in size from 9 to 823 participants. Most data were collected from hospital-wide clinics. The scales used investigated redness, rash, skin loss, incontinence type, infection symptoms, skin color, edema, patient experience, pain, and perineal care habits. Both validity and reliability of the scales were examined in eight of the studies; in one study, only reliability was examined because the scale validity was shown in previous research. Moreover, sensitivity and specificity were indicated in one study. CONCLUSIONS: There are several competent scales in the literature with proven validity and reliability that can be used to diagnose IAD.

Protective equipment-related pressure ulcers in healthcare workers during COVID-19 pandemic: A systematic review.

AIM: This systematic review was carried out to examine pressure ulcers in healthcare staff due to the use of protective equipment during COVID-19 pandemic and the precautions taken to prevent these injuries. METHOD: Relevant studies were retrospectively searched. Seven English keywords identified from MESH were used while searching. The search was carried out in five international databases by trying various combinations of these words during February 15-25, 2021. This systematic review was updated by rescanning databases on December 20, 2021 and a total of 611 studies were attained. RESULTS: 17 studies which met the study inclusion criteria, which were conducted mostly through online survey method in different study designs and which included a total of 24,889 healthcare professionals were examined. The incidence of PPE-related pressure ulcers was found to be between 30% and 92.8%. Grade I pressure ulcers were the most common (44.1%-82%). The incidence of skin problems except PPE-related pressure ulcers such as itching, redness and dry skin was found to be between 42.8-88.1%. Risk factors that frequently played a role in the development of PPE-related pressure ulcers and other skin problems were longer use of PPE and sweating. PPE-related pressure ulcers and other skin problems were more frequent over the nose (nasal bone/nasal bridge), ears, forehead and cheeks. PPE-related itching, redness and dry skin mostly occurred. Several dressing applications were found to be effective in the prevention of PPE-related pressure ulcers and other skin problems that might develop especially on the facial region. CONCLUSION: PPE-related pressure ulcers and other skin problems were found to be higher among healthcare professionals. Data regarding the sealing of dressing applications against viral transmission in the prevention of PPE-related pressure ulcers and other skin problems are limited. It is estimated that future studies will be performed to prevent device-related pressure ulcers in healthcare workers. It is suggested that there is a need to conduct studies with larger samples where expert researchers make observations for pressure ulcers in order to determine the prevalence and incidence of PPE-related pressure ulcers.

The Use of the Braden Scale in Assessing Pressure Ulcers in Turkey: A Systematic Review.

OBJECTIVE: The goal of this systematic review was to reach scientific generalizations regarding the assessment of risk for pressure ulcers based on the results of previous studies that made use of the Braden Scale. DATA SOURCES: This research was performed by using a retrospective screening of studies relevant to the subject. In Turkey, the first validity and reliability study for the Braden Scale was performed by Oguz and Olgun in 1998. For this reason, the authors' research was conducted between March 2, 2012, and August 4, 2012, as a systematic review analysis by evaluating studies in Turkey that made use of the Braden Scale between 1998 and 2012. Screening was performed by using different combinations of 8 keywords in Turkish and English to scan a total of 10 national and international databases. A total of 2375 studies were evaluated, and 16 studies were included and considered within the context of this research. RESULTS AND CONCLUSIONS: It was determined that the studies considered within the context of the current research were conducted between 1998 and 2012; 5 of these studies were experimental and 11 were descriptive; the sample size varied between 22 and 422; the majority were performed in intensive care units; and the study samples were mostly composed of patients. The Braden Scale was used in these studies for forming samples by identifying high-risk patients. Two studies evaluated the reliability of the Braden Scale, whereas 7 other studies calculated the reliability coefficient. Only 1 study included results for sensitivity, specificity, positive predictive value, and negative predictive value (which represent the predictive criteria of assessment tools). Four studies indicated cutoff values, which varied between 14 and 18. A general evaluation of these studies' results revealed limited evidence of effective risk assessment by the Braden Scale.