Things to think about when you are considering moisture –
· does your patient have an issue of moisture.( this is not all about continence )
· This element talks about linen changes this could mean episodes of being wet/ moist or pad changes.
· Remember night time your patient could be wet for up to 12 hours? /
Incontinence
Does your patient have a moisture lesion?
Does your patient have infrequent toileting or pad changes?
Can your patient not get to the toilet without assistance?
Is the patient concordant with their continence plan?
Do they have episodes of time when they are sitting in wet clothes or pads?
Do they only have care in the day (is the skin moist when their pad is removed in the morning?)
Are they incontinent of faeces?
Does their catheter leak?
Have they had a proper continence assessment? /
Wound exudate
Are they having the right treatment -
Does your patient have a leaking wound?
Do they have the right absorbent pad on / how often is it changed?
Does your patient have oedema which leaks (e.g. large leaky legs is this being well managed)?
Does your patient have macerated periwound skin? /
Examples
Constantly moist / Very moist / Occasionally moist / Rarely moist
· Unmanaged incontinence
· Unmanaged wound exudate
· Leaky legs
· Constantly sweaty / · Wet overnight but not in the day.
· Pad changes 3- times a day
· Pads which are not absorbent enough
· Patient who refuses to be changed. / · Patient has the odd accident
· Patient leaks urine at times
· Wound exudate is managed until later in the day.
· Patients sweats a lot but is cleaned regularly by carer / · Patient is continent
· Manages body temperature
· Wound exudate is contained
Microclimate
Does your patient glow – is very sweaty? (This could mean you could score them as constantly wet.)
Do they have a raised temperature? (This can cause patients to sweat) do they have an infection?
Are they bedbound?( having multiple covers on reduced air flow to the skin)
Seating – what is the cushion material made of, does it make the patient sweaty around the bottom?
Can they move off their bottom to cool it down?
Are they wearing clothes that does not wick away moisture?(nylon manmade fibres that do not wick away moisture)
Is your patient large with lots of skinfolds e.g. –under the breasts under the pannus (stomach flap)? /
Other
Trench foot
Leaky legs which have not been managed draining down into footwear.
Obsessive washing and bathing
Damp and moist environment( home environment ) …
Some chronic conditions can make you sweat
Excessive weight and skin folds . /
Author S Warner /Gdrive /e-learning /Braden e-learning/associated documents /draft1 april2015