Structure |
- Deficit of material and human resources to meet the needs of the hospitalized elderly person and physical structure of the hospital institutions that do not favor the safe mobility for bathrooms use. Authors cited low illumination, lack of support bars, non-slip flooring and high beds as an example of this adverse structure(44 Furlanetto K, Emond K. "Will I come home incontinent?" A retrospective file review: incidence of development of incontinence and correlation with length of stay in acute settings for people with dementia or cognitive impairment aged 65 years and over. Collegian[Internet]. 2016[cited 2017 Dec 12];23(1):79-86. Available from: http://www.collegianjournal.com/article/S1322-7696(14)00112-7/pdf
http://www.collegianjournal.com/article/...
,77 Nyman MH, Forsman H, Ostaszkiewicz J, Hommel A. Urinary incontinence and its management in patients aged 65 and older in orthopaedic care: what nursing and rehabilitation staff know and do. J Clin Nurs. 2017;26(21):3345-53. doi: 10.1111/jocn.13686 https://doi.org/10.1111/jocn.13686...
). - Lack of institutional protocols and validated scales to guide the practice of using absorbent urinary devices such as diapers, used, most of the time, indiscriminately and without justification recorded in medical records(55 Zisberg A, Gary S, Gur-Yaish N, Admi H, Shadmi E. In-hospital use of continence aids and new-onset urinary incontinence in adults aged 70 and older. J Am Geriatr Society. 2011;59:1099-104. doi: 10.1111/j.1532-5415.2011.03413.x https://doi.org/10.1111/j.1532-5415.2011...
6 Zisberg A. Incontinence brief use in acute hospitalized patients with no prior incontinence. J Wound Ostomy Continence Nurs. 2011;38(5):559-64. doi: 10.1097/WON.0b013e31822b3292 https://doi.org/10.1097/WON.0b013e31822b...
7 Nyman MH, Forsman H, Ostaszkiewicz J, Hommel A. Urinary incontinence and its management in patients aged 65 and older in orthopaedic care: what nursing and rehabilitation staff know and do. J Clin Nurs. 2017;26(21):3345-53. doi: 10.1111/jocn.13686 https://doi.org/10.1111/jocn.13686...
-88 Sourdet S, Lafont C, Rolland Y, Nourhanshemi F, Andrieu S, Vellas B. Preventable iatrogenic disability in elderly patients during hospitalization. J Am Med Dir Assoc. 2015;18(16):674-81. doi: 10.1016/j.jamda.2015.03.011 https://doi.org/10.1016/j.jamda.2015.03....
,1414 Blanc BFL, Granados GL, Burillo JMT, Montealegre ALR, Octavio IA, León AG. Appropriateness of the use of incontinence absorbent products in hospitalized adults. Enferm Clín. 2015;25(4):198-203. doi: 10.1016/j.enfcli.2015.06.001 https://doi.org/10.1016/j.enfcli.2015.06...
-1515 Bitencourt GR, Alves LAF, Santana RF. Practice of use of diapers in hospitalized adults and elderly: cross-sectional study. Rev Bras Enferm [Internet]. 2018[cited 2017 Dec 12];71(2):343-9. Available from: http://www.scielo.br/pdf/reben/v71n2/0034-7167-reben-71-02-0343.pdf
http://www.scielo.br/pdf/reben/v71n2/003...
,2020 Ostaszkiewicz J, O'Connell B, Millar L. Incontinence: managed or mismanaged in hospital settings? Int J Nurs Pract. 2008;14:495-502. doi: 10.1111/j.1440-172X.2008.00725.x https://doi.org/10.1111/j.1440-172X.2008...
). - Institutional routine that favors the use of diaper and permanent bladder catheter, in detriment to encouragement of autonomy with the use of toilets, urinals and trimers(44 Furlanetto K, Emond K. "Will I come home incontinent?" A retrospective file review: incidence of development of incontinence and correlation with length of stay in acute settings for people with dementia or cognitive impairment aged 65 years and over. Collegian[Internet]. 2016[cited 2017 Dec 12];23(1):79-86. Available from: http://www.collegianjournal.com/article/S1322-7696(14)00112-7/pdf
http://www.collegianjournal.com/article/...
5 Zisberg A, Gary S, Gur-Yaish N, Admi H, Shadmi E. In-hospital use of continence aids and new-onset urinary incontinence in adults aged 70 and older. J Am Geriatr Society. 2011;59:1099-104. doi: 10.1111/j.1532-5415.2011.03413.x https://doi.org/10.1111/j.1532-5415.2011...
-66 Zisberg A. Incontinence brief use in acute hospitalized patients with no prior incontinence. J Wound Ostomy Continence Nurs. 2011;38(5):559-64. doi: 10.1097/WON.0b013e31822b3292 https://doi.org/10.1097/WON.0b013e31822b...
,88 Sourdet S, Lafont C, Rolland Y, Nourhanshemi F, Andrieu S, Vellas B. Preventable iatrogenic disability in elderly patients during hospitalization. J Am Med Dir Assoc. 2015;18(16):674-81. doi: 10.1016/j.jamda.2015.03.011 https://doi.org/10.1016/j.jamda.2015.03....
,1313 Regat-Bikoï C, Vuagnat, H, Morin D. Urinary incontinence in hospitalized geriatric patients: is it really a priority for nurses? Rech Soins Infirm[Internet]. 2013[cited 2017 Dec 12];115(4):59-67. Available from: https://www.cairn.info/revue-recherche-en-soins-infirmiers-2013-4-page-59.htm
https://www.cairn.info/revue-recherche-e...
14 Blanc BFL, Granados GL, Burillo JMT, Montealegre ALR, Octavio IA, León AG. Appropriateness of the use of incontinence absorbent products in hospitalized adults. Enferm Clín. 2015;25(4):198-203. doi: 10.1016/j.enfcli.2015.06.001 https://doi.org/10.1016/j.enfcli.2015.06...
15 Bitencourt GR, Alves LAF, Santana RF. Practice of use of diapers in hospitalized adults and elderly: cross-sectional study. Rev Bras Enferm [Internet]. 2018[cited 2017 Dec 12];71(2):343-9. Available from: http://www.scielo.br/pdf/reben/v71n2/0034-7167-reben-71-02-0343.pdf
http://www.scielo.br/pdf/reben/v71n2/003...
-1616 Tavares JPA, Silva ALD, Sá-Couto P, Boltz M, Capezuti E. Portuguese nurses' knowledge of and attitudes toward hospitalized older adults. Scand J Caring Sci. 2015;29(1):51-61. doi: 10.1111/scs.12124 https://doi.org/10.1111/scs.12124...
,2020 Ostaszkiewicz J, O'Connell B, Millar L. Incontinence: managed or mismanaged in hospital settings? Int J Nurs Pract. 2008;14:495-502. doi: 10.1111/j.1440-172X.2008.00725.x https://doi.org/10.1111/j.1440-172X.2008...
). |
Process |
- Non-recognition of the problem, resulting in lack of actions to promote continence and prevention of UI by the care team(77 Nyman MH, Forsman H, Ostaszkiewicz J, Hommel A. Urinary incontinence and its management in patients aged 65 and older in orthopaedic care: what nursing and rehabilitation staff know and do. J Clin Nurs. 2017;26(21):3345-53. doi: 10.1111/jocn.13686 https://doi.org/10.1111/jocn.13686...
,1313 Regat-Bikoï C, Vuagnat, H, Morin D. Urinary incontinence in hospitalized geriatric patients: is it really a priority for nurses? Rech Soins Infirm[Internet]. 2013[cited 2017 Dec 12];115(4):59-67. Available from: https://www.cairn.info/revue-recherche-en-soins-infirmiers-2013-4-page-59.htm
https://www.cairn.info/revue-recherche-e...
,1515 Bitencourt GR, Alves LAF, Santana RF. Practice of use of diapers in hospitalized adults and elderly: cross-sectional study. Rev Bras Enferm [Internet]. 2018[cited 2017 Dec 12];71(2):343-9. Available from: http://www.scielo.br/pdf/reben/v71n2/0034-7167-reben-71-02-0343.pdf
http://www.scielo.br/pdf/reben/v71n2/003...
16 Tavares JPA, Silva ALD, Sá-Couto P, Boltz M, Capezuti E. Portuguese nurses' knowledge of and attitudes toward hospitalized older adults. Scand J Caring Sci. 2015;29(1):51-61. doi: 10.1111/scs.12124 https://doi.org/10.1111/scs.12124...
17 Tang HJ, Tang HYJ, Hu FW, Chen CH. Changes of geriatric syndromes in older adults survived from Intensive Care Unit. Geriatr Nurs. 2016;38(3):219-24. doi: 10.1016/j.gerinurse.2016.10.011 https://doi.org/10.1016/j.gerinurse.2016...
-1818 Sabin Z, Susi S, René S. Urinary incontinence in hospitalised elderly patients: do nurses recognise and manage the problem? Nurs Res Pract. 2011;5. doi: 10.1155/2011/671302 https://doi.org/10.1155/2011/671302...
,2020 Ostaszkiewicz J, O'Connell B, Millar L. Incontinence: managed or mismanaged in hospital settings? Int J Nurs Pract. 2008;14:495-502. doi: 10.1111/j.1440-172X.2008.00725.x https://doi.org/10.1111/j.1440-172X.2008...
). - Deficit of professional knowledge and misconceptions about UI in the elderly(44 Furlanetto K, Emond K. "Will I come home incontinent?" A retrospective file review: incidence of development of incontinence and correlation with length of stay in acute settings for people with dementia or cognitive impairment aged 65 years and over. Collegian[Internet]. 2016[cited 2017 Dec 12];23(1):79-86. Available from: http://www.collegianjournal.com/article/S1322-7696(14)00112-7/pdf
http://www.collegianjournal.com/article/...
,77 Nyman MH, Forsman H, Ostaszkiewicz J, Hommel A. Urinary incontinence and its management in patients aged 65 and older in orthopaedic care: what nursing and rehabilitation staff know and do. J Clin Nurs. 2017;26(21):3345-53. doi: 10.1111/jocn.13686 https://doi.org/10.1111/jocn.13686...
,1616 Tavares JPA, Silva ALD, Sá-Couto P, Boltz M, Capezuti E. Portuguese nurses' knowledge of and attitudes toward hospitalized older adults. Scand J Caring Sci. 2015;29(1):51-61. doi: 10.1111/scs.12124 https://doi.org/10.1111/scs.12124...
17 Tang HJ, Tang HYJ, Hu FW, Chen CH. Changes of geriatric syndromes in older adults survived from Intensive Care Unit. Geriatr Nurs. 2016;38(3):219-24. doi: 10.1016/j.gerinurse.2016.10.011 https://doi.org/10.1016/j.gerinurse.2016...
-1818 Sabin Z, Susi S, René S. Urinary incontinence in hospitalised elderly patients: do nurses recognise and manage the problem? Nurs Res Pract. 2011;5. doi: 10.1155/2011/671302 https://doi.org/10.1155/2011/671302...
). - Installation of diapers and devices after the problem already installed, as the only strategy used by the nursing team to manage UI during hospitalization of the elderly(55 Zisberg A, Gary S, Gur-Yaish N, Admi H, Shadmi E. In-hospital use of continence aids and new-onset urinary incontinence in adults aged 70 and older. J Am Geriatr Society. 2011;59:1099-104. doi: 10.1111/j.1532-5415.2011.03413.x https://doi.org/10.1111/j.1532-5415.2011...
6 Zisberg A. Incontinence brief use in acute hospitalized patients with no prior incontinence. J Wound Ostomy Continence Nurs. 2011;38(5):559-64. doi: 10.1097/WON.0b013e31822b3292 https://doi.org/10.1097/WON.0b013e31822b...
7 Nyman MH, Forsman H, Ostaszkiewicz J, Hommel A. Urinary incontinence and its management in patients aged 65 and older in orthopaedic care: what nursing and rehabilitation staff know and do. J Clin Nurs. 2017;26(21):3345-53. doi: 10.1111/jocn.13686 https://doi.org/10.1111/jocn.13686...
-88 Sourdet S, Lafont C, Rolland Y, Nourhanshemi F, Andrieu S, Vellas B. Preventable iatrogenic disability in elderly patients during hospitalization. J Am Med Dir Assoc. 2015;18(16):674-81. doi: 10.1016/j.jamda.2015.03.011 https://doi.org/10.1016/j.jamda.2015.03....
,1313 Regat-Bikoï C, Vuagnat, H, Morin D. Urinary incontinence in hospitalized geriatric patients: is it really a priority for nurses? Rech Soins Infirm[Internet]. 2013[cited 2017 Dec 12];115(4):59-67. Available from: https://www.cairn.info/revue-recherche-en-soins-infirmiers-2013-4-page-59.htm
https://www.cairn.info/revue-recherche-e...
14 Blanc BFL, Granados GL, Burillo JMT, Montealegre ALR, Octavio IA, León AG. Appropriateness of the use of incontinence absorbent products in hospitalized adults. Enferm Clín. 2015;25(4):198-203. doi: 10.1016/j.enfcli.2015.06.001 https://doi.org/10.1016/j.enfcli.2015.06...
15 Bitencourt GR, Alves LAF, Santana RF. Practice of use of diapers in hospitalized adults and elderly: cross-sectional study. Rev Bras Enferm [Internet]. 2018[cited 2017 Dec 12];71(2):343-9. Available from: http://www.scielo.br/pdf/reben/v71n2/0034-7167-reben-71-02-0343.pdf
http://www.scielo.br/pdf/reben/v71n2/003...
-1616 Tavares JPA, Silva ALD, Sá-Couto P, Boltz M, Capezuti E. Portuguese nurses' knowledge of and attitudes toward hospitalized older adults. Scand J Caring Sci. 2015;29(1):51-61. doi: 10.1111/scs.12124 https://doi.org/10.1111/scs.12124...
,2020 Ostaszkiewicz J, O'Connell B, Millar L. Incontinence: managed or mismanaged in hospital settings? Int J Nurs Pract. 2008;14:495-502. doi: 10.1111/j.1440-172X.2008.00725.x https://doi.org/10.1111/j.1440-172X.2008...
). - Subregistration, underreporting and lack of screening of the problem by the nursing team(44 Furlanetto K, Emond K. "Will I come home incontinent?" A retrospective file review: incidence of development of incontinence and correlation with length of stay in acute settings for people with dementia or cognitive impairment aged 65 years and over. Collegian[Internet]. 2016[cited 2017 Dec 12];23(1):79-86. Available from: http://www.collegianjournal.com/article/S1322-7696(14)00112-7/pdf
http://www.collegianjournal.com/article/...
,77 Nyman MH, Forsman H, Ostaszkiewicz J, Hommel A. Urinary incontinence and its management in patients aged 65 and older in orthopaedic care: what nursing and rehabilitation staff know and do. J Clin Nurs. 2017;26(21):3345-53. doi: 10.1111/jocn.13686 https://doi.org/10.1111/jocn.13686...
,1313 Regat-Bikoï C, Vuagnat, H, Morin D. Urinary incontinence in hospitalized geriatric patients: is it really a priority for nurses? Rech Soins Infirm[Internet]. 2013[cited 2017 Dec 12];115(4):59-67. Available from: https://www.cairn.info/revue-recherche-en-soins-infirmiers-2013-4-page-59.htm
https://www.cairn.info/revue-recherche-e...
,1515 Bitencourt GR, Alves LAF, Santana RF. Practice of use of diapers in hospitalized adults and elderly: cross-sectional study. Rev Bras Enferm [Internet]. 2018[cited 2017 Dec 12];71(2):343-9. Available from: http://www.scielo.br/pdf/reben/v71n2/0034-7167-reben-71-02-0343.pdf
http://www.scielo.br/pdf/reben/v71n2/003...
-1616 Tavares JPA, Silva ALD, Sá-Couto P, Boltz M, Capezuti E. Portuguese nurses' knowledge of and attitudes toward hospitalized older adults. Scand J Caring Sci. 2015;29(1):51-61. doi: 10.1111/scs.12124 https://doi.org/10.1111/scs.12124...
,1919 Wagg A, Potter J, Peel P, Irwin P, Lowe D, Pearson M. National audit of continence care for older people: management of urinary incontinence. Age Ageing. 2008;37(1):39-44. doi: 10.1093/ageing/afm163 https://doi.org/10.1093/ageing/afm163...
-2020 Ostaszkiewicz J, O'Connell B, Millar L. Incontinence: managed or mismanaged in hospital settings? Int J Nurs Pract. 2008;14:495-502. doi: 10.1111/j.1440-172X.2008.00725.x https://doi.org/10.1111/j.1440-172X.2008...
). |
Results |
- High incidence and prevalence of UI in hospitalized elderly people(44 Furlanetto K, Emond K. "Will I come home incontinent?" A retrospective file review: incidence of development of incontinence and correlation with length of stay in acute settings for people with dementia or cognitive impairment aged 65 years and over. Collegian[Internet]. 2016[cited 2017 Dec 12];23(1):79-86. Available from: http://www.collegianjournal.com/article/S1322-7696(14)00112-7/pdf
http://www.collegianjournal.com/article/...
5 Zisberg A, Gary S, Gur-Yaish N, Admi H, Shadmi E. In-hospital use of continence aids and new-onset urinary incontinence in adults aged 70 and older. J Am Geriatr Society. 2011;59:1099-104. doi: 10.1111/j.1532-5415.2011.03413.x https://doi.org/10.1111/j.1532-5415.2011...
6 Zisberg A. Incontinence brief use in acute hospitalized patients with no prior incontinence. J Wound Ostomy Continence Nurs. 2011;38(5):559-64. doi: 10.1097/WON.0b013e31822b3292 https://doi.org/10.1097/WON.0b013e31822b...
7 Nyman MH, Forsman H, Ostaszkiewicz J, Hommel A. Urinary incontinence and its management in patients aged 65 and older in orthopaedic care: what nursing and rehabilitation staff know and do. J Clin Nurs. 2017;26(21):3345-53. doi: 10.1111/jocn.13686 https://doi.org/10.1111/jocn.13686...
-88 Sourdet S, Lafont C, Rolland Y, Nourhanshemi F, Andrieu S, Vellas B. Preventable iatrogenic disability in elderly patients during hospitalization. J Am Med Dir Assoc. 2015;18(16):674-81. doi: 10.1016/j.jamda.2015.03.011 https://doi.org/10.1016/j.jamda.2015.03....
,1313 Regat-Bikoï C, Vuagnat, H, Morin D. Urinary incontinence in hospitalized geriatric patients: is it really a priority for nurses? Rech Soins Infirm[Internet]. 2013[cited 2017 Dec 12];115(4):59-67. Available from: https://www.cairn.info/revue-recherche-en-soins-infirmiers-2013-4-page-59.htm
https://www.cairn.info/revue-recherche-e...
14 Blanc BFL, Granados GL, Burillo JMT, Montealegre ALR, Octavio IA, León AG. Appropriateness of the use of incontinence absorbent products in hospitalized adults. Enferm Clín. 2015;25(4):198-203. doi: 10.1016/j.enfcli.2015.06.001 https://doi.org/10.1016/j.enfcli.2015.06...
-1515 Bitencourt GR, Alves LAF, Santana RF. Practice of use of diapers in hospitalized adults and elderly: cross-sectional study. Rev Bras Enferm [Internet]. 2018[cited 2017 Dec 12];71(2):343-9. Available from: http://www.scielo.br/pdf/reben/v71n2/0034-7167-reben-71-02-0343.pdf
http://www.scielo.br/pdf/reben/v71n2/003...
,2020 Ostaszkiewicz J, O'Connell B, Millar L. Incontinence: managed or mismanaged in hospital settings? Int J Nurs Pract. 2008;14:495-502. doi: 10.1111/j.1440-172X.2008.00725.x https://doi.org/10.1111/j.1440-172X.2008...
). - Return to the home of previously hospitalized elderly people with acquired UI(44 Furlanetto K, Emond K. "Will I come home incontinent?" A retrospective file review: incidence of development of incontinence and correlation with length of stay in acute settings for people with dementia or cognitive impairment aged 65 years and over. Collegian[Internet]. 2016[cited 2017 Dec 12];23(1):79-86. Available from: http://www.collegianjournal.com/article/S1322-7696(14)00112-7/pdf
http://www.collegianjournal.com/article/...
5 Zisberg A, Gary S, Gur-Yaish N, Admi H, Shadmi E. In-hospital use of continence aids and new-onset urinary incontinence in adults aged 70 and older. J Am Geriatr Society. 2011;59:1099-104. doi: 10.1111/j.1532-5415.2011.03413.x https://doi.org/10.1111/j.1532-5415.2011...
-66 Zisberg A. Incontinence brief use in acute hospitalized patients with no prior incontinence. J Wound Ostomy Continence Nurs. 2011;38(5):559-64. doi: 10.1097/WON.0b013e31822b3292 https://doi.org/10.1097/WON.0b013e31822b...
,88 Sourdet S, Lafont C, Rolland Y, Nourhanshemi F, Andrieu S, Vellas B. Preventable iatrogenic disability in elderly patients during hospitalization. J Am Med Dir Assoc. 2015;18(16):674-81. doi: 10.1016/j.jamda.2015.03.011 https://doi.org/10.1016/j.jamda.2015.03....
,1313 Regat-Bikoï C, Vuagnat, H, Morin D. Urinary incontinence in hospitalized geriatric patients: is it really a priority for nurses? Rech Soins Infirm[Internet]. 2013[cited 2017 Dec 12];115(4):59-67. Available from: https://www.cairn.info/revue-recherche-en-soins-infirmiers-2013-4-page-59.htm
https://www.cairn.info/revue-recherche-e...
,1616 Tavares JPA, Silva ALD, Sá-Couto P, Boltz M, Capezuti E. Portuguese nurses' knowledge of and attitudes toward hospitalized older adults. Scand J Caring Sci. 2015;29(1):51-61. doi: 10.1111/scs.12124 https://doi.org/10.1111/scs.12124...
-1717 Tang HJ, Tang HYJ, Hu FW, Chen CH. Changes of geriatric syndromes in older adults survived from Intensive Care Unit. Geriatr Nurs. 2016;38(3):219-24. doi: 10.1016/j.gerinurse.2016.10.011 https://doi.org/10.1016/j.gerinurse.2016...
,2020 Ostaszkiewicz J, O'Connell B, Millar L. Incontinence: managed or mismanaged in hospital settings? Int J Nurs Pract. 2008;14:495-502. doi: 10.1111/j.1440-172X.2008.00725.x https://doi.org/10.1111/j.1440-172X.2008...
). |