Christine Berke

Even with the best of plans and good briefs, ancillary products can play a major role in incontinence care. But caregivers need to do their homework. Taking the appropriate time to make wise choices can make all the difference in outcomes, experts remind.

1. Use products with a positive record of efficacy.

Working with a company with a broad product line based on clinical needs can be a big plus, said Michelle Christiansen, vice president of clinical sales and marketing for the Medline Personal Care Division. 

The care taken during the products’ formulation also is important. This includes ensuring the highest standards are followed in choosing ingredients.

Skin care products developed by leading specialists that undergo continuous and rigorous product research and refinement also are important.

Christiansen advises choosing products with formulations that are clinically proven. 

“It’s also important to leverage these resources to help caregivers use the right products, the right way, at the right time,” she said. “Color-coded and educational packaging, by usage, helps standardize inventory, simplify training and may reduce the chance of staff error and ultimately improve outcomes.”

2. Providers need to follow the formularies in place.

There are multiple reasons for using formularies as a guide when choosing these kinds of incontinence-related skin care products.

Almost all items offered by the manufacturers of skin care or incontinence product lines have been tested and developed with specific skin care in mind for those receiving services, according to Christine Berke, MSN, a nurse practitioner at a midwestern wound and ostomy clinic. She also is a preceptor and guest lecturer at UNMC Colleges of Medicine and Nursing.

“If a caregiver provides services in a facility, the facility should have a formulary for skin and bathing care products,” Berke said.  “Usually these products are designed to be pH-balanced (neutral around 7.0 pH) and free of known chemicals that may irritate compromised skin.”

She tells caregivers to consult facility policies and guidelines “and ask lots of questions of the manufacturer representatives.” It’s their job to be responsive.

Queries may fairly — and most often should — include requests for items like testing data, user case studies or white paperss. 

Like Christiansen, Berke advises working with a supplier with a broad skin care product line.

Request testing data, if available, and review real-word case studies  that have been conducted among product users that are closely matched to the patients your facility serves. 

3. Consider ancillaries’ possible interactions.

Caregivers should be mindful of the way products interact with the patient’s skin and other incontinence products.

That advice comes from Bonnie Grady, senior product manager, Briefs and Skincare, Essity Health and Medical Solutions.

Also choose products that don’t hide affected areas. Instead, use materials that allow the caregiver to visualize the skin after application, Grady said. For example, many zinc products provide effective protection, but are difficult to remove and prevent proper assessment of the coverage area.

Products that remain in place while being easy to remove are a huge plus, Grady said. 

For example, avoid thick pastes or creams. Remember: Damage can occur to sensitive skin when multiple swipes are required to remove any skin care product.

Finally, choose products that, when properly applied, will not coat the inside of the incontinence brief.

“When this happens, the brief is then inadvertently ‘waterproofed,’ preventing proper absorption of fluids,” Grady said. “This can create the potential for greater moisture-associated skin damage.”

4. Realize the critical manner and sequence in which various products are used.

During each absorbent product change, no-rinse cleansing should occur, Grady says. An oil-in-water emulsion will properly moisturize the skin and be free of surfactants.

“If your cleansing product does not provide moisturization, a second product/step will be required,” she added.

Berke cautions caregivers to use these products shortly after skin cleansing to prevent over-dryness.

“We always want to ensure we are using products and techniques that are going to not only lead to great outcomes clinically, but also ensure we are promoting dignity and comfort,” said Christiansen. “We also want to make sure that we have products that go hand-in-hand with the outcome we are trying to achieve.” 

This includes cleansers, hydrating moisturizers, barriers, protectants and treatments for fungal infections and to relieve associated symptoms.