Moisture Associated Skin Damage (MASD) affects 28.3% of older adults 65+ in the United States

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Reply to both.
1. Moisture Associated Skin Damage (MASD) affects 28.3% of older adults 65+ in the United States (Banharak et al., 2021). Often this is associated with urinary or fecal incontinence (Banharak et al., 2021). The use of a barrier product can reduce the risk of developing MASD and associated medical complications. This leads to the problem statement; There is a lack of knowledge relating to proper use of barrier creams for MASD prevention and promotion of wound healing.
Study variables for this study would include current skin health, incontinence frequency, incontinence type (urinary, fecal, or both), age, and mobility. Another major factor for skin health and wound prevention is dietary health. Chew et al. (2022) highlighted that older adults in community-dwellings often face malnutrition and poor protein intake putting them at greater risk of developing injuries and wounds.
This topic would be researched by reviewing data from multiple studies and medical sites for information on the prevention of MASD for older adults with incontinence. The information would be grouped according to the type of intervention and compared for effectiveness. The interventions would also need to be assessed for proper use. The intervention of barrier cream use could show minimal effect, but the intervention is implemented improperly.
This topic will positively impact the community by reducing the prevalence of MASD in older adults. This would reduce the strain on medical workers and the healthcare system overall by reducing the resources allocated to MASD treatment. Lotfolah et al. (2020) note that care of a single deep tissue could increase staff workload by up to 50%. This shows that prevention of MASD can drastically decrease strain on the healthcare system.
2. In the United States, there are one in six youth from 6-17 years old who experience a mental health disorder every year (National Alliance on Mental Illness, 2020). Sadly, suicide is the second leading cause of death in youth from 10-34 in the United States (National Alliance on Mental Illness, 2020). Some of the mental health disorders that youth struggle with are anxiety, depression, and self-harm (DeFosset et al., 2017). School districts are in a unique position to be able to serve the youth, but it still remains a problem for students to become engaged or take part in counseling sessions (DeFosset et al., 2017). It is important that school counselors come up with creative ways to engage students in counseling sessions, which leads me to my problem statement. There is a lack of knowledge about the knowledge between the use of animal assisted therapy and school counseling. 
     Variables that will be studied are the amount of time spent with the animal during the session, student engagement, the specific mental health disorders it improved, the animal that was used for the counseling session, “emotional-social support and sense of belongingness” improvement (Yordy et al, 2020). It is also important that ethical considerations be kept in mind as well. Some are receiving consent from parent or guardian for their child to participate in animal assisted therapy, risk of harm by any of the animals used, and past trauma from animals.
     The hypothesis that is hoped for is an improvement in the mental health of youth aged from kindergarten to 18 years of age. School counselors as well as other mental health professionals that “carefully planned interactions” between the child and animals has been an effective therapeutic intervention (Jalongo & Guth, 2022). With the use of animal assisted therapy, it has been shown to provide an “accepting, non judgemental presence that focuses young children’s attention, motivates them to learn, and encourages participation in planned intervention activities” (Jalongo & Guth, 2022). It will also bring about positive School Nurse practice as they are a “liaison between optimal health and academic success” and can connect students to counselors so that they can participate in animal assisted therapy (Fedor, 2018). 

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