3M™ Cavilon™ Advanced Skin Protectant for IAD

‹#›© 3M 2016. All Rights Reserved.

Table of Contents

Meeting Goals01 Value Summary: Cavilon Advanced Skin Protectant

02Incontinence Associated Dermatitis Landscape▪ Overview of IAD▪ Burden of Illness

03Cavilon Advanced Skin Protectant for moderate to severe IAD▪ Description of Cavilon Advanced Skin Protectant▪ Clinical Value▪ Economic Value

04 Appendix A: Bibliography

s

01 Value Summary 3M™ Cavilon™ Advanced Skin Protectant


1Gray, JWOCN 2007;34(1): 45-54; 2Plante, Association for Advancement of Wound Care. Atlanta, Ga.;1996. 3 Morris L. Wounds UK 2011; 7(2): 88-93 4 Beeckman, Wounds International 2015 5 Junkin, Nursing 2008;38(11 Suppl):56hn1-10 6 CMS HCAPS 7 Demarre, J Adv Nurs 2014; Aug 19 8 Park, J WOCN 2014; 41(5): 424-29 9Gray M. J WOCN 2012;39(1):61-74 10 Bliss D. J WOCN 2011;38(4):433-445 11Hart J. Nursing Scotland 2002, Issue: July/August 12Zehrer CL. Ostomy Wound Manage 2005; 51(12): 54-58;

Incontinence-associated dermatitis (IAD) occurs frequently, is time-consuming, costly to manage, and painful for patientsDefinition • Incontinence-associated dermatitis (IAD) is skin damage associated with urine and/or fecal exposure1

Burden of IAD • IAD is common1, resource intensive2,3 and costly • IAD is associated with pain and discomfort, with downstream impact on patient’s quality of life4,5, and perceived quality of

care6 • IAD is a known risk factor for pressure ulcers7,8 and secondary fungal infections4

Prevention and Management of IAD

• Prevention is aimed at avoiding or minimizing exposure to urine or stool combined with a structured skin care regimen4,9

• For management of IAD, the skin care regimen should protect the skin from further exposure to irritants, establish a healing environment, and eradicate any cutaneous infection4,9

• Lack of a clinically effective and patient and clinician friendly product for moderate to severe IAD and high risk patients• Evidence suggests that IAD persists despite the use of current skin care regimens10

• Current products can be time-consuming for clinicians, requiring frequent application and removal3• Current products can interfere with absorbent products that are used in the management of IAD11,12

• The frequent removal and reapplication of current products is painful for the patient5

IAD challenges


Evidence suggests that IAD persists despite the use of standardized skin care regimens1

Critically Ill Adults1 81% of patients still had IAD at discharge from the ICU (median time in ICU = 7days)

81%at 7 days

In a study of critically ill patients (n=45) across 3 surgical/trauma critical care units in urban US hospitals, the median time to onset was 4 days (1-6 days) and 81% of ICU patients still had IAD at discharge (median of 7 days) with the median time to IAD healing of 11 days (range, 1-19 days).

1Bliss D, J WOCN 2011;38(4):433-445


Cavilon Advanced Skin Protectant is an effective barrier that helps in prevention and management of moderate to severe IAD

Cavilon Advanced Skin Protectant adheres to wet, weepy tissue, creating an effective barrier to caustic irritants and allowing skin to heal in the most extreme cases1

Cavilon Advanced Skin Protectant can reduce patient’s pain1 associated with IAD, improving quality of life and the patient’s experience

Cavilon Advanced Skin Protectant reduces frequency of applications to 2-3 times per week and reduces nursing time

1Brennan MR et al. JWOCN. Accepted for publication 2016.

Cavilon Advanced

Skin Protectant

Reduces pain

associated with IAD

care

Durable

Adheres to wet, weepy

tissue

s

02 Incontinence Associated Dermatitis (IAD) LandscapeOverview


Incontinence-associated dermatitis (IAD) can range in severity from erythema to partial-thickness skin loss and infection1

1Beekman et al, Wounds international 2015.

Category 1(Mild IAD )

Category 2(Moderate-to-Severe IAD)

• Erythema +/- edema• Affected skin is red* but intact

• Erythema +/- edema; +/- vesicles/bullae/skin erosion; +/- denudation of skin; +/- skin infection

• Affected skin is red* with skin breakdown

Incontinence-associated dermatitis (IAD) is a skin damage associated with urine and/or fecal exposure

*Or paler, darker, purple, dark red or yellow in patients with darker skin tones

Moderate Severe


High risk patients are those with fecal incontinence, especially where loose stool is present

Urine

Formed feces+/- urine

All patients or residents with incontinence are at risk but those with mixed incontinence are the most vulnerable especially when stools are liquid or diarrhea is present1

high risk population

Type of incontinence

IAD

Ris

k

Severe-to-moderate IAD occurs in ~35% of cases2

9%

26%65%

Mild

Moderate

Severe

Liquid feces +/- urine

Liquid stool increases the risk and severity of IAD

1Beekman et al, Wounds international 2015; 2Gray M and Baros S. Presented at the 23rd Annual Meeting of the Wound Healing Society; SAWC Spring/WHS Joint Meeting, Denver, CO May 1-5, 2013.


IAD is a risk factor for pressure injury (ulcer) development1-3

Patients with IAD are at a significantly higher risk of superficial sacral pressure ulcers1

The risk of developing pressure ulcers has been found to increase as the severity score

for IAD increases2

The likelihood of developing a pressure ulcer increases by a ratio of 1.9 for every 1-point increase in IAD severity score (odds ratio = 1.9, 95% CI = 1.237-2.917)2

Superficial sacral pressure ulcers developed in 44.4% of patients who had IAD versus 12.2% of patients who did not have IAD (n=610)1

Patients with IAD are at an increased risk of superficial sacral pressure ulcers with an odds ratio of 2.99 (CI: 1.20-7.52, p=0.19)1

1.9odds ratio

44%

2.99odds ratio

1Demarre, J Adv Nurs 2014;Aug 19; 2Park KH, J WOCN 2014;41(5):424-29; 3Beeckman, Wounds International 2015


IAD is associated with pain, discomfort, depression, and poor quality of life1

“You have to manage time, as well as the patient’s pain and discomfort. And then there is this anguish that starts because we see it very clearly. The patients are on a respirator, so we feel it right away, the machines ring loudly, the cardiac rhythm increases, the pressure increases. . . they dread it. Before we have even touched them.”4

-Nurse responding to impact of diarrhea on nurses’ everyday work

Pain associated with IAD can have a negative impact on patients’ health and well-being1-3

Pote

ntia

l in

cre

ase

in

leng

th

of

stay

2

Poor

qu

alit

y of

lif

e1

Red

uce

d qu

alit

y of

ca

re3

Dec

rea

sed m

obili

ty2In

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ased

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orbi

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2Pai

n

1Beeckman, Wounds International 2015; 2Junkin, Nursing 2008;38(11 Suppl):56hn1-10; 3CMS HCAHPS; 4Guillemin, Int J Nurs Pract. 2015 May 1;21(S2):38-45


Skin integrity and pain management are recognized as key indicators of quality of care1,3

Pain Management Questions

How often was your pain well controlled? How often did the hospital staff do everything they could to help you with your pain?1

Pain management is one of nine key topics reported in the Centers for Medicare and Medicaid Services (CMS) Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores1

National results for Pain Management Questions 71%22%7%

Never + Sometimes Usually Always

Represents over 3 Million patients discharged from 4,136 hospitals between July 2013 and June 20142

1CMS HCAHPS; 2CMS HCAHPS Hospital Characteristic Chart; 3Meraviglia, Adv Skin Wound Care 2002;15(1):24-9; 4https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/r8som.pdf

Joint Commission for Accreditation of Health Care Organizations and the Centers for Medicare and Medicaid Services (CMS) recognize skin breakdown as a key indicator for quality of care4

Quality

s

02 Incontinence Associated Dermatitis (IAD) LandscapeBurden of Illness


IAD is a common problem Although IAD is known to be a common problem, wide variation in reported IAD prevalence and incidence exists. This is likely due to differences across care settings and the diagnosis of IAD6

36%25.6%

IAD incidence for patients with FI in the critical care setting1

[NLD]IAD prevalence of incontinent patients in academic hospitals2

42%IAD prevalence for incontinent patients in the hospital setting3

22.8%IAD prevalence for patients in the LTAC setting4

Range of reported prevalence and incidence6

Prevalence Incidence3.4%5.6%

25%

50% High Low

FI = Fecal incontinenceLTAC = Long term acute care

1Bliss et al. J Wound Ostomy Continence Nurs. 2011; 2Kottner et al. Int J Nurs Stud. 2014; 3Campbell et al. Int Wound J. 2014; 4Long et al. J Wound Ostomy Continence Nurs. 2012; 5Gray M and Bartos S. Presented at the 23rd Annual Meeting of the Wound Healing Society. 2013;6Gray M et al. Journal of Wound, Ostomy and Continence Nursing. 2007;7Nix and Haugen. Drugs Aging 2010;27(6):491-6

43%IAD prevalence for incontinent patients in the acute care setting5

41%Nursing home residents with IAD7


Incontinence Associated Dermatitis (IAD) is a frequent complication of urinary and/or fecal incontinence13

0%

13%

25%

38%

50%

20%

7%

22%

46% 42%

33%

Urinary Incontinence1-4

Fecal Incontinence4-7

Double (fecal and urinary)

Incontinence8-12

Prevalence of incontinence in acute care settings

Prev

alen

ce ra

nge

repo

rted

in th

e lit

erat

ure

IAD occurs in 43%13 of patients with urinary or

fecal incontinence

1Nair, Aust J Ageing 2000;19(2):81-4. ; 2daSilva, Rev Esc Enferm USP 2005;39(1):36-45; 3Mecocci, Dement Geriatr Cogn Disord 2005;20:260-2. 4Sgadari, Age Ageing 1997;26(Suppl 2):49-54.; 5Fonda, Aust Clin Rev 1988;8(30):102-7; 6Bliss, Nurs Res 2000;49:101-8, 7Schultz, Urol Nurs 1997;17:23-8; 8Nelson, JAMA 1995;274(7):559-61; 9Nelson, Dis Colon Rectum 1998;41:1226-9; 10Ouslander, J Am Geriatr Soc 1993;41:1083-9; 11Ouslander, JAMA 1982;248:1149-98; 12Lyder, J ET Nurs 1992; 19 (1): 12-6 7; 13Gray, JWOCN 2007;34(1):45-54


IAD is time-consuming to manage

x x17 minutes33 seconds

x 6 3.86hrs./day

1 patient with liquid stool

1Heidegger et al. International Journal of Nursing Studies 59 (2016) 163–168; 2Bliss et al. J WOCN 2007;34(2):143-152; 3Bayon-Garcia. Intensive and Critical Care Nursing (2012) 28, 242—250

=

“Fifty percent (50%) of nurses reported that the management of a patient with diarrhea caused them to work overtime once a month, while for 17% of nursing aides and 5% of nurses this happened once a week.”1

2 nurses†

Above calculation was based on a questionnaire completed and returned by 146 of the 204 ICU caregivers, corresponding to 75% of answers among nurses and 73% among nursing aides in Switzerland1. † Two nurses are the standard of care to clean and position a patient.Another survey of 962 questionnaires completed by nurses (60%), physicians (29%) and pharmacists or purchasing personnel (11%) in Germany (n=94), Italy (n=165), Spain (n=144) and the UK (n=127) estimated that one patient experiencing five episodes of fecal incontinence would consume 3.75 hours of nursing time3

6 episodes/day2


IAD is costly to manage

3.86 hours/day1,2

(assumes 2 nurses x 17.5 min x 6 episodes )

x6

episodes /day4

~$713per week

/ IAD patient1 patient with IAD for 1 week

1Bayon-Garcia et al. Intensive and Critical Care Nursing (2012) 28, 242—250; 2Heidegger et al. International Journal of Nursing Studies 59 (2016) 163–168 3Bureau of Labor Statistics (median hourly cost of Nursing Assistant) http://www.bls.gov/oes/current/oes311014.htm; 4Bliss et al. JWOCN 2007;34(2):143-152;5Wilson, Obstetrics & Gynecology, 2001;98(3):398-406; 6Wagner and Hu, Urology. 1998;51:355-361; 7Woo KY. Int Wound J 2014; 11:431–437

=$25.81

per hour3(Blend of RN & CNA)

+ x$0.27-0.45

midpoint of $0.364

Nursing time $697.39/wk.

Barrier + cleanser cost$15.12/wk.

Solid data on the cost of IAD is lacking, however, available estimates confirm that IAD can be costly to manage• Total estimated cost of IAD in the US in 1995 was $136.3 million6 in nursing home residents with urinary incontinence• In a separate study, Wilson et al. estimated the 1995 cost of moderate-to-severe IAD at $69-$504 per episode5 for the institutionalized elderly • A more recent study conducted in 2014 estimated the weekly cost of managing IAD at $127.197 in Canada. This included the cost of

products (assumed to be petroleum-based creams) and nursing time.

6

http://www.bls.gov/oes/current/oes311014.htm



s

03 Cavilon Advanced Skin Protectant for moderate to severe IADProduct Description


Product Description:• The protective barrier creates an environment that allows healing1,2

◦ In a case series evaluating Cavilon Advanced Skin Protectant for management of severe IAD, a WOC Nurse described the performance of the product as “miraculous” when she observed the rapid improvement in skin condition.

• The product is durable requiring reapplication only 2-3 times per week1

• The product adheres to, and forms a barrier on wet, weeping tissue1,2

• The product forms a barrier that helps to control minor bleeding and weeping of serous fluid2

• The liquid is non-stinging and comfortable during application, wear and cleansing1

• The protective film coating reduces pain associated with Incontinence Associated Dermatitis (IAD)1

• The product attaches to the skin and does not require removal1

• The product allows easy cleansing - stool and other soil can be easily removed without disturbing the film1

• The product is transparent allowing visualization of the underlying skin1

• The product is a single use device minimizing the risk of cross-contamination1

Cavilon Advanced Skin Protectant is a novel barrier used for patients with, or at risk of moderate-to-severe IAD

1Brennan, Accepted for publication in JWOCN 2016 2Been R. Accepted for publication in Wound Repair & Regeneration. DOI: 10.1111/wrr.12455. (In an animal model – translations to humans not shown.)


Cavilon Advanced Skin Protectant was designed to be the ideal barrier product to prevent and manage IAD per best practice recommendations1 Characteristics of Ideal Products

• Clinically proven to prevent and/or treat IAD

• Low irritant potential/hypoallergenic

• Does not sting on application

• Transparent or can be easily removed for skin inspection

• Removal/cleansing considers caregiver time and patient comfort

• Does not increase skin damage

• Does not interfere with the absorption or function of incontinence management products

• Compatible with other products used (e.g. adhesive dressings)

• Acceptable to patients, clinicians and caregivers

• Minimizes number of products, resources and time required to complete skin care regimen

• Cost-effective

1Beeckman, Wounds International 2015. Available to download from www.woundsinternational.com

s

03 Cavilon Advanced Skin Protectant for moderate to severe IADClinical Value


Proven to adhere to wet, weepy tissue; creating a healing environment

Cavilon Advanced Skin Protectant showed significant (p=0.013) improvement for patients with severe IAD (n=16); 4 of the 12 patients with epidermal skin loss had complete re-epithelialization with 4-6 applications of the product. 1

Untreated wounds produced 1.9 times more fluid (4.328 g) compared to wounds treated with Cavilon Advanced Skin Protectant (2.231 g) (N=6, preclinical)2

18.3% greater re-epithelization (p=0.003, 95% CI= 9.2%-27.5%) was seen in wounds covered with Cavilon Advanced Skin Protectant compared to untreated wounds (N=7)2

1Brennan, Accepted for publication in JWOCN 2016 2Been R. Accepted for publication in Wound Repair & Regeneration. DOI: 10.1111/wrr.12455. (In an animal model – translations to humans not shown.

Cavilon Advanced Skin Protectant adheres to wet, weepy tissue, protecting the skin from irritants and creating an environment to allow healing1

Cavilon Advanced

Skin Protectant

Reduces pain

associated with IAD

care

Durable


tissue


Cavilon Advanced Skin Protectant has been shown to significantly improve severe cases of IAD even in the presence of continued incontinence1

IAD

Sco

re*

Patient Number (n=16)2 4 8 1 13 9 14 11 12 7 15 6 16 5 10 3

615 300

900

00 00 00 4 00 00 00 00 34 102 234

623

84 390

124

900

48 64 79 120 144 144 187 252 322 660

1,429

1,884 1,956 IAD Score at enrollment IAD Score at study end

Results from 16 patients with severe IAD from two facilities providing nursing care 24h/day1

*IAD Score: Sum of 6 zones scored using the 3M Skin Assessment Tool

• The IAD score improved in 13 of 16 patients with severe IAD • The median percent improvement in IAD score was 96%, significantly

different from zero, p=0.013 by Wilcoxon Signed-Rank test • Four of the 12 patients with epidermal skin loss had complete re-

epithelialization with 4-6 applications of the product

1Brennan, MR. Accepted for publication in JWOCN 2016


Cavilon Advanced Skin Protectant protects skin even in the presence of a caustic irritant1

In a pre-clinical animal model, a single application of Cavilon Advanced Skin Protectant prevented skin breakdown from simulated incontinence fluid and provided protection for at least 48 hours

The average normalized irritation score was 0.2 for Cavilon Advanced Skin Protectant protected wounds and 1.7 for untreated wounds

Untreated sites had 8.5 times more irritation compared to sites treated with Cavilon Advanced Skin Protectant

1 Been R. Accepted for publication in Wound Repair & Regeneration. DOI: 10.1111/wrr.12455 (http://onlinelibrary.wiley.com/doi/10.1111/wrr.12455/abstract). (In an animal model – translations to humans not shown.)

aver

age

norm

aliz

ed ir

ritat

ion

scor

e

-0

0.3

0.5

0.8

1.0

1.3

1.5

1.8

2.0

Cavilon Advanced Skin Protectant

Untreated control

1.7

0.2

Mean skin irritation scores at 48 hours after caustic challenge in guinea pig intact skin model (n=24)

P < 0.001

Score Clinician Erythema Assessment scale 0 Clear skin with no signs of erythema

1 Almost clear; slight redness

2 Mild erythema, definite redness

3 Moderate erythema; marked redness

4 Severe erythema; fiery redness

http://onlinelibrary.wiley.com/doi/10.1111/wrr.12455/abstract


Cavilon Advanced Skin Protectant provides an environment for re-epithelization even in the presence of a caustic irritant1

In a pre-clinical animal model, 18.3% greater re-epithelization (p=0.003, 95% CI= 9.2%-27.5%) was seen in partial thickness wounds covered with Cavilon Advanced Skin Protectant compared to untreated woundsUntreated sites had 8.5 times more irritation compared to sites treated with Cavilon Advanced Skin Protectant

“The unique characteristics of the new skin protectant, along with the environment it provided for skin protection, resulted in a greater degree of re-epithelialization despite the continued presence of a simulated caustic fluid.”

P = 0.003

Mea

n %

wou

nd re

-epi

thel

ializ

atio

n

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%


Untreated

62.2%

80.6%

N = 70 N = 65

Mean percent wound re-epithelialization at 96 hours in porcine partial-thickness wound model




Cavilon Advanced Skin Protectant significantly reduced the amount of weeping exudate1

In a pre-clinical animal model, there was a significant (p=0.001) reduction in the amount of exudate weeping from partial thickness wounds over 96 hours following a single application of Cavilon Advanced Skin Protectant

Untreated wounds produced 1.9 times more fluid (4.328 g) compared to wounds treated with Cavilon Advanced Skin Protectant (2.231 g)

“The results indicate that the formulation helped reduce the amount of minor bleeding and weeping from wounds compared to untreated wounds, and that this effect could last at least 96 hours.”

Flui

d Ab

sorb

ed (g

)

0.0

1.3

2.5

3.8

5.0


Untreated control

4.328

2.231

0.238 0.083

Immediately (p=0.001) 96 hours (p<0.001)

Mean weight of fluid absorbed with gauze immediately and 96 hours after wound creation in porcine partial-thickness wound




A durable product1 that eliminates the need for frequent applications

Cavilon Advanced Skin Protectant need only be applied 2-3 times per week

Cavilon Advanced Skin Protectant has proven durablility, requiring less frequent applications and reducing nursing time required to prevent and manage IAD

Cavilon Advanced

Skin Protectant

Reduces pain

associated with IAD

care

Durable


tissue


Cavilon Advanced Skin Protectant is highly durable which reduces frequent applications

Assumes 6 episodes/day1 x 7 days

Cavilon Advanced Skin Protectant is highly durable, requiring application 2 to 3 times per week, instead of with every cleansing2

Many products require application with every episode of incontinence…

~42applications / week

2-3applications / week

Minimizing frequent contact with damaged skin may help promote healing and reduce patient discomfort

associated with IAD and IAD care

1Bliss et al. J WOCN 2007;34(2):143-152. 2Brennan, Accepted for publication in JWOCN 2016.


Cavilon Advanced

Skin Protectant

Reduces pain

associated with IAD

care

Durable

Eliminates difficult cleansing and does not require product removal minimizing irritating and frequent contact with damaged skin


tissue

Cavilon Advanced Skin Protectant is easy to cleanse , does not require removal and is applied 2-3 times per week

100% of patients who reported IAD-associated pain on Day 1 (n=9), saw a reduction in pain with the use of Cavilon Advanced Skin Protectant1

Better patient comfort can improve patient experience and perceived quality of care

Cavilon Advanced Skin Protectant can help reduce patient’s pain1 associated with IAD and IAD care

1Brennan, Accepted for publication in JWOCN 2016


Cavilon Advanced Skin Protectant can help reduce patient’s pain1 associated with IAD and IAD care

Pain

Sco

re

Patient Number*

8 12 4 11 15 16 7 5 14 1 1000

2

0

3

110

2

00 00

778888

101010

Pain at Day 1 Pain at study end

100% of patients reporting pain on Day 1 saw a reduction in pain with the

use of Cavilon Advanced Skin Protectant, with baseline pain scores

of 7-10 reduced to 0-3.

*Study enrolled 16 patients with severe IAD. 4 patients were unresponsive or paraplegic and 2 patients (No. 1 and 10) reported no pain throughout the study. 1 patient’s pain score were missing.

1Brennan, Accepted for publication in JWOCN 2016

0 = No pain; 10 = Worst pain


Cavilon Advanced Skin Protectant does not need to be removed and can help reduce patient pain and discomfort1 associated with IAD and IAD care

Cavilon Advanced Skin Protectant does not require removal and is transparent, allowing inspection of damaged skin

Assumes 6 episodes per day2 x 7 days

Many paste/ointment products require removal during cleansing in order to inspect the wound

~42product removal/week

0

Minimizing frequent contact with damaged skin can reduce patients’ pain and discomfort associated

with IAD and IAD care

product removal/week

1Brennan, Accepted for publication in JWOCN 2016 2Bliss et al. J WOCN 2007;34(2):143-152

s

03 Cavilon Advanced Skin Protectant for moderate to severe IADEconomic Value


Cavilon Advanced Skin Protectant can reduce nursing time to manage IAD

Application Time: 1 min 01 sec1

Cleansing Time: 13 mins 32 sec1,2,3

6 episodes per day1 for an average case of urinary and fecal incontinence

20.4 hours per week per average IAD patient

Potential savings of 16.5 hours

per week per average IAD patient


zinc oxide paste

What could you accomplish with more time?

2 nurses†

2 nurses†3.9 hours per week

per average IAD patient**Application Time*: 0 min 45 sec2

Cleansing Time: 2 mins4

* Time reported as per application* 3 applications per week† Two nurses are the standard of care to clean and position a patient1Bliss D. JWOCN 2007; 34(2):143-152 2Heidegger CP. International J of Nursing Studies. 2016 Jul 31; 59:163-8 3Lewis-Byers K. Ostomy Wound Manage. 2002; 48(12):44-51. 4 Brennan MR. Accepted for publication in JWOCN 2016


Cavilon Advanced Skin Protectant can reduce nursing time to manage IAD

Application Time: 1 min 01 sec1

Cleansing Time: 13 mins 32 sec1,2,350.9 hours per week

per average IAD patient

Potential savings of 41.3 hours

per week per severe IAD patient


zinc oxide paste

What could you accomplish with more time?

2 nurses†

2 nurses†9.6 hours per week

per average IAD patient**Application Time*: 0 min 45 sec2

Cleansing Time: 2 mins4

1Bliss D. JWOCN 2007; 34(2):143-152 2Heidegger CP. International J of Nursing Studies. 2016 Jul 31; 59:163-8 3Lewis-Byers K. Ostomy Wound Manage. 2002; 48(12):44-51. 4 Brennan MR. Accepted for publication in JWOCN 2016

15 episodes per day for a severe case of fecal incontinence

15-episode example

* Time reported as per application* 3 applications per week† Two nurses are the standard of care to clean and position a patient


Cavilon Advanced Skin Protectant can reduce total overall cost

6 episodes per day1 for an average case of urinary and fecal incontinence

20.4 hours per week


zinc oxide paste

2 nurses†

2 nurses†

$33.23 per hour2

3.9 hours per week

$33.23 per hour2

6 times per day

3 timesper week

$0.29 per application

$9.00 per application

$677 per week

$129 per week

$12 per week

$27 per week

1Bliss D. JWOCN 2007; 34(2):143-152 2 Bureau of Labor Statistics. Occupational Employment Statistics for 31-1014 Nursing Assistant. (May 2015). Accessed on 5/18/2016 <http://www.bls.gov/oes/current/oes311014.htm>

6!

3!

Potential savings of $533

per week per IAD patient

† Two nurses are the standard of care to clean and position a patient

s

04 Appendix A: Bibliography


Bayon-Garcia C, Binks R, De Luca E, Dierkes C et al. Prevalence, management and clinical challenges associated with acute faecal incontinence in the ICU and critical care settings: The FIRSTTM cross-sectional descriptive survey. Intensive and Critical Care Nursing (2012) 28, 242—250Beeckman D et al. Proceedings of the Global IAD Expert Panel. Incontinence associated dermatitis: moving prevention forward. Wounds International 2015. Available to download from www.woundsinternational.comBeen R, Bernatchez SF, Conrad-Vlasak D, Asmus R, Eckholm B, Parks PJ. In vivo methods to evaluate a new skin protectant for loss of skin integrity. Accepted for publication in Wound Repair & Regeneration. DOI: 10.1111/wrr.12455 (http://onlinelibrary.wiley.com/doi/10.1111/wrr.12455/abstract)Bliss D, Incontinence-Associated Dermatitis in Critically Ill Adults Time to Development, Severity, and Risk Factors. J WOCN 2011;38(4):433-445Bliss D, Zehrer C, Savik K, Smith G, Hedblom E. An Economic Evaluation of Four Skin Damage Prevention Regimens in Nursing Home Residents With Incontinence. J WOCN 2007;34(2):143-152.Bliss DZ, Johnson S, Savik K, Clabots CR, Gerding DN. Fecal incontinence in hospitalized patients who are acutely ill. Nurs Res 2000;49:101-8.Brennan MR, Milne CT, Agrell-Kann M, Ekholm BP. Clinical evaluation of a barrier film for the management of incontinence associated dermatitis (IAD) in an open label, non-randomized, prospective study. Accepted for publication in Journal of Wound, Ostomy, and Continence Nursing (JWOCN).Bureau of Labor Statistics. Occupational Employment Statistics for 31-1014 Nursing Assisant. (May 2015). Accessed on 5/18/2016 <http://www.bls.gov/oes/current/oes311014.htm>Campbell et al. Incontinence-associated dermatitis: a cross-sectional prevalence study in the Australian acute care hospital setting. Int Wound J. 2014 Jun 26

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http://www.woundsinternational.com/



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