Adult Skin Care Protocols

• These are study notes for Adult Skin Care Protocols

Skin Cleanser - Rinse Gentle Rain

• Indicated for cleansing skin and hair in the shower/bath
• Ensures complete rinsing
• Not for bedside bathing and should not be diluted
• Applied to a moist cloth or directly to skin
• Gently wash then rinse off and pat skin dry
• For hair, apply to wet hair, lather, and rinse well
• Product contains a fragrance

Skin Cleanser - No Rinse Remedy Foam Cleanser

• Indicated for cleansing skin and hair, especially during bedside bathing when a shower/bath isn't possible
• Product should not be diluted
• For a complete bath, use a max of 10 pumps
• Dispense 1-3 pumps onto a moist cloth or directly to skin/soiled area; then gently wash, do not rinse, but pat dry instead
• Repeat for other body areas
• Apply to wet or dry hair and gently work into hair strands, but do not rinse and dry with a towel

Moisturizer Remedy Nourishing Cream

• Serves to maintain skin health and prevent skin tears
• Can be used to treat dry skin but should not be used for the prevention of IAD (Incontinence Associated Dermatitis)
• Apply a thin layer to clean, slightly damp skin
• Do not apply between the toes
• Ensure socks/shoes are worn to prevent falls
• For maintenance, apply daily after a shower/bath on still-moist skin
• To prevent skin tears, apply twice per day
• For dry skin, apply twice per day

Protectant Silicone 24% Remedy Hydraguard Cream

• Indicated for the prevention and treatment of Mild-Moderate IAD and very dry, cracked skin
• Acts as a barrier around wounds/drains/tubes
• Apply a thin layer to the area
• If using around a wound/tube/drain, allow to dry for 1-2 minutes before applying a dressing
• Product may not be compatible with silicone dressings
• Do not apply the cream between the toes
• Ensure socks and shoes are worn to prevent falls
• For IAD, use after every incontinence episode
• For very dry, cracked skin, apply twice per day
• For peri-wound/tube/drain MASD, apply as ordered

Protectant Zinc 30% Secura Extra Protective Cream (EPC)

• Indicated for the treatment of Moderate-Severe IAD and prevention of IAD in the case of severe diarrhea due to C. difficile or gastro-intestinal conditions
• Apply cream to the palm of the hand and apply in one direction, letting the cream "follow your hand" and do not rub
• Apply a thick (5mm) layer to ensure skin is not visible through the cream and repeat until the affected area is covered

Cleansing during Incontinence Episode:

• Use No-Rinse Foam Cleanser on a moist cloth directly onto the soiled area
• Cleanse only the soiled cream and reapply more EPC cream as needed
• Do not remove all EPC with every incontinence episode
• To treat IAD/prevent IAD, use after every incontinent episode

Removal of All EPC for Skin Assessment

• Done every 3 days or as needed
• Apply No-Rinse Foam cleanser directly onto the EPC
• Let it sit for 2-3 minutes, then wipe with a moist, soft cloth and repeat until all cream is removed

Advanced Moisturizer Urea 10% AHA 4% Atrac-Tain Cream

• Intended for the treatment of extremely dry skin; specifically on the feet/lower legs and renal failure/diabetes
• AHA is effective for removing flaky skin, allowing Urea moisturizer to penetrate the skin
• Not indicated for the purposes of basic skin moisturization, unless there is specific other direction from client
• Ensure a care plan is in place; developed by the NSWOC/RN/RPN as per PISheet
• Remove any dead skin using an appropriate basic cleanser
• Pat dry to remove excess moisture but not to the point of being completely dry
• Spread cream and rub into the skin
• Do not apply between toes
• May sting if applied to irritated/broken skin
• Prior to application, test cream on a small area to assess client's tolerance
• Apply twice a day and when all the dead skin is removed, move to a basic moisturizer

Skin Fold Gauze - PHMB AMD/PHMB Gauze

• Indicated for the treatment of intertrigo and works to prevent moisture in finger/toe webs, skin folds and is useful when handling contractures
• Cleanse with appropriate basic cleanser
• Pat area dry, then use guaze; be sure guaze is in contact with the entirety of the skin fold and in toes/weave ribbons into the webspaces
• Do not wrap the digit in the event of weaving as this may cut off blood flow
• Do not use with creams, ointments, powders, sprays, polysporin, petrolatum-based products or antifungals products
• Apply at least daily and whenever soiled/moist

Skin Fold Textile/Cloth - Silver InterDry Ag Sheet

• Prevents and treats intertrigo with moisture in skin folds as well as finger/toe web spaces and hands with client contractures when at risk for local infection or has S&S infection
• Cut the sheet lengthwise or width-wise, not just along the dotted line
• Cleanse w/ appropriate basic cleanser (Remedy Cleanser) for the first day
• Pat dry before laying smooth sheet into base of skin fold and ensure 5cm of sheet is outside, exposed for air to secure PRN
• Write date on the exposed part of the sheet
• During days 2, 3, 4 & 5 only remove sheet daily and cleanse skins, then pat dry and reposition same piece as previously stated
• Do not use creams, ointments,powders, sprays, polysporin, petrolatum-based products or antifungals
• Assess daily and change sheet on Day 5 or earlier if soiled; expect discoloration of the sheet

Hydrophilic Wound Dressing Triad

• Requires a current wound treatment plan
• A zinc-based paste dressing that adheres to moist/weeping areas and when exposed to air, dries to provide a cover-like dressing
• Application of the dressing paste can be delegated to HCAs/HSWs per agency policy (RN/RPN/LPN must've done this initial application)
• This product is not a barrier cream and must be applied in one-direction, with a thickness of 3mm over the affected area
• To apply, be sure the skin is not visible through the cream
• Allow drying for ≈15-20 min
• If patient can't be moved, apply cover dressing over the paste
• Note that the Triad will wipe off if not allowed to dry or if is not protected
• Frequency of change should be as per care plan
• To remove, apply No-Rinse Foam Cleanser directly onto Triad-covered area and let sit for 2-3 minutes then wipe with a soft, moist cloth, before repeating until the cream is all removed