Bladder management in adult care homes. Review of a program in North Carolina

Urinary Incontinence in Older Adults Takes Collaborative Nursing Efforts to Improve

There is a misconception that urinary incontinence (UI) in older adults, usually above the age of 65 is a part of aging. More than 50% of residents in long-term care (LTC) settings are affected by UI and it is associated in many cases with markedly reduced quality of life. It has become evident that incontinence can be cured or successfully managed. However, many nurses lack sufficient knowledge to intervene appropriately. The purpose of this review is to share how the collaborative efforts of nurses at all levels may lead to increased assessment and interventions of UI in this population.

Nursing Staff Beliefs and Expectations About Continence Care in Nursing Homes

OBJECTIVE

The purpose of this qualitative study was to consider the current beliefs of nursing assistants and directors of nursing about management of urinary incontinence (UI) among the residents in nursing homes.

DESIGN

This was a qualitative study using purposive sampling and a focus group methodology.

SETTING AND SUBJECTS

Three focus groups including 38 participants were held in 2 different regions. Two of the focus groups comprised nursing assistants and 1 comprised directors of nursing.

METHOD

The focus groups were facilitated by 2 different advanced practice nurses (BR and LJK), and 2 similar interview guides were used: 1 for the nursing assistants and 1 for the nurses. The interviews were tape recorded and transcribed verbatim; data were analyzed via content analysis.

RESULTS

Ten themes were identified from the data; 3 focused on resident factors that influence UI, 4 related to staff and family contributors to UI, and 3 focused on recommendations to improve UI management in the nursing home setting.

CONCLUSIONS

The findings from this study can be used to guide interventions to decrease or eliminate barriers to continence care and thereby facilitate the implementation of clinical practice guidelines and evidence-based interventions to improve urinary continence among nursing home residents.

Future directions for incontinence research with frail elders

BACKGROUND

The most vulnerable older adults are often referred to as the frail elderly. There is a high prevalence of urinary incontinence (UI) in this population, yet there is little research to guide nurses in providing effective continence care to this vulnerable group of elders.

OBJECTIVES

To summarize current knowledge on UI in frail older adults and suggest future areas for research in this population.

METHODS

Existing literature about UI in the frail elderly was analyzed to generate a plan for future research.

RESULTS

Gaps exist in the knowledge base needed to guide the nursing care of incontinent frail elders in the following areas: effectiveness of interventions, caregiver characteristics and management models, prevalence, risk factors, and reliability and validity of outcome measures. There are barriers to conducting research in long-term care settings.

CONCLUSIONS

Despite the challenges inherent in doing research with incontinent frail elders, there is an urgent need for research to guide the nursing care of this population in all healthcare settings.