The use of incontinence devices and urinary/ faecal diversion management devices in hospitalised patients as a possible cause of unwanted immobilization
Authors:
A. Pokorná 1,2; V. Štrombachová 2; P. Búřilová 1,2; M. Pospíšil 1,2; J. Mužík 1,2; J. Kučerová 2; D. Dolanová 1,2
Authors place of work:
Ústav zdravotnických věd, LF MU, Brno
1; Oddělení hodnocení kvality, Ústav, zdravotnických informací a statistiky, Praha
2
Published in the journal:
Cesk Slov Neurol N 2022; 85(Supplementum 1): 28-33
doi:
https://doi.org/10.48095/cccsnn2022S28
Summary
Backgrounds: The study aims to identify potential adverse patient immobilizations related to inappropriate use of incontinence devices and urinary/faecal diversion devices in the clinical practice of inpatient health care providers (HCPs) in the Czech Republic. Methods: Cross-sectional prevalence study. The data were collected from 14 inpatient HCPs in the Czech Republic (38 wards were involved: seven internal medicine, 15 rehabilitation, two geriatric, and 14 long-term care wards). Results: The data from a total of 1,133 hospitalized patients were analyzed (of which 594; 52.5%) were provided with urinary derivation aids and equipment). Incontinence diaper was the most commonly used in patients in all study wards (N = 251; 22.2%); permanent urinary catheter (PUC) was recorded in 196 (17.3%) patients and incontinence diaper + PUC in 144 (12.7%) patients. According to ICD-10, Diseases of the circulatory system (I00–I99) (N = 132; 22.3%) were the most common principal diagnoses. Most patients monitored for urinary/stool continence using a urinary catheter and/or incontinence diapers were hospitalized in long-term care facilities (N = 331; 55.8%). Diuretics were the most common group of drugs with the potential to affect patient mobility (N = 221; 37.3%). Conclusion: the study results did not support the potential immobilization of patients through inappropriate use of incontinence and urinary management device but identified the documentation errors when using restrictive measures.
Keywords:
immobility – adverse patient immobilizations – incontinence aids – urinary/faecal management
Zdroje
1. Pokorná A, Komínková A, Menšíková A et al. Ošetřovatelské postupy založené na důkazech. 2. vyd. Brno: Masarykova univerzita 2019.
2. Holroyd-Leduc JM, Sen S, Bertenthal D et al. The relationship of indwelling urinary catheters to death, length of hospital stay, functional decline, and nursing home admission in hospitalized older medical patients. J Am Geriatr Soc 2007; 55 (2): 227–33. doi: 10.1111/j.1532-5415.2007.01064.x.
3. Jiang W, Song Y, Zhang H et al. Inappropriate initial urinary catheter placement among older Chinese hospital inpatients: an observational study. Int J Nurs Pract 2020; 26 (2): e12791. doi: 10.1111/ijn.12791.
4. Hu FW, Chang CM, Tsai CH et al. Exploring initial inappropriate use of urinary catheters among hospitalised older patients in Taiwan. J Clin Nurs 2015; 24 (11–12): 1656–1665. doi: 10.1111/jocn.12767.
5. Gorecki C, Brown JM, Nelson EA et al. Impact of pressure ulcers on quality of life in older patients: a systematic review. J Am Geriatr Soc 2009; 57 (7): 1175–1183. doi: 10.1111/j.1532-5415.2009.02307.x.
6. Wu X, Li Z, Cao J et al. The association between major complications of immobility during hospitalization and quality of life among bedridden patients: a 3 month prospective multi-center study. PloS One 2018; 13 (10): e0205729. doi: 10.1371/journal.pone.0205729.
7. Dellinger EP. Prevention of hospital-acquired infections. Surg Infect (Larchmt) 2016; 17 (4): 422–426. doi: 10.1089/sur.2016.048.
8. Chou CL, Lee WR, Yeh CC et al. Adverse outcomes after major surgery in patients with pressure ulcer: a nationwide population-based retrospective cohort study. PloS One 2015; 10 (5): e0127731. doi: 10.1371/journal.pone.0127731.
9. Theisen S, Drabik A, Stock S. Pressure ulcers in older hospitalised patients and its impact on length of stay: a retrospective observational study. J Clin Nurs 2012; 21 (3–4): 380–387. doi: 10.1111/j.1365-2702.2011.03915.x.
10. Dick AW, Perencevich EN, Pogorzelska-Maziarz M et al. A decade of investment in infection prevention: a cost-effectiveness analysis. Am J Infect Control 2015; 43 (1): 4–9. doi: 10.1016/j.ajic.2014.07.014.
11. Krupová L, Pokorná A. Quality of life in patients with non-healing wounds. Cesk Slov Neurol N 2019; 82/115 (Suppl 1): S40–S43. doi: 10.14735/amcsnn2019 S40.
12. Pokorná A, Štrombachová V, Mužík J et al. Národní portál Systém hlášení nežádoucích událostí. Praha: Ústav zdravotnických informací ČR. 2016 [online]. Dostupné z URL: https: //shnu.uzis.cz.
13. Vyhláška č. 243/2021 Sb. Vyhláška, kterou se mění vyhláška č. 134/1998 Sb., kterou se vydává seznam zdravotních výkonů s bodovými hodnotami, ve znění pozdějších předpisů, Částka 103/2021.
14. Jain P, Parada JP, David A et al. Overuse of the indwelling urinary tract catheter in hospitalized medical patients. Arch Intern Med 1995; 155 (13): 1425–1429.
15. Dingwall L, McLafferty E. Do nurses promote urinary continence in hospitalized older people? An exploratory study. J Clin Nurs 2006; 15 (10): 1276–1286. doi: 10.1111/j.1365-2702.2006.01381.x.
16. Fakih MG, Watson SR, Greene MT et al. Reducing inappropriate urinary catheter use: a statewide effort. Arch Intern Med 2012; 172 (3): 255–260. doi: 10.1001/archinternmed.2011.627.
17. Fernandez-Lasquetty Blanc B, Lorente Granados G, Tenías Burillo JM et al. Adecuación del uso de absorbentes de incontinencia urinaria en pacientes adultos ingresados en un hospital. Enferm Clin 2015; 25 (4): 198–203. doi: 10.1016/j.enfcli.2015.06.001.
18. Bitencourt GR, Alves LA, Santana RF. Practice of use of diapers in hospitalized adults and elderly: cross-sectional study. Rev Bras Enferm 2018; 71 (2): 343–349. doi: 10.1590/0034-7167-2016-0341.
19. Pokorná A, Benešová K, Mužík J et al. Sledování dekubitálních lézí u pacientů s neurologickým onemocněním – analýza Národního registru hospitalizovaných. Cesk Slov Neurol N 2016; 79/112 (Suppl 1): S8–S14. doi: 10.14735/amcsnn2016S8.
20. Varghese D, Ishida C, Haseer Koya H. Polypharmacy. Treasure Island (FL): StatPearls Publishing 2021.
21. Beezer J, Al Hatrushi M, Husband A et al. Polypharmacy definition and prevalence in heart failure: a systematic review. Heart Fail Rev 2021; 27 (2): 465–492. doi: 10.1007/s10741-021-10135-4.
22. Pazan F, Wehling M. Polypharmacy in older adults: a narrative review of definitions, epidemiology and consequences. Eur Geriatr Med 2021; 12 (3): 443–452. doi: 10.1007/s41999-021-00479-3.
23. Whitman A, Erdeljac P, Jones C et al. Managing polypharmacy in older adults with cancer across different healthcare settings. Drug Healthc Patient Saf 2021; 13: 101–116. doi: 10.2147/DHPS.S255893.
24. Abu-Naser D. Impact of clinical pharmacist interventions in prescribing errors in hospitalized diabetic patients with major polypharmacy. Hosp Pharm 2021; 56 (4): 392–399. doi: 10.1177/0018578720985428.
25. Tasai S, Kumpat N, Dilokthornsakul P et al. Impact of medication reviews delivered by community pharmacist to elderly patients on polypharmacy: a meta-analysis of randomized controlled trials. J Patient Saf 2021; 1 (4): 290–298. doi: 10.1097/PTS.0000000000000599.
26. Wong ES. Guideline for prevention of catheter-associated urinary tract infections. Am J Infect Control 1983; 11 (1): 28–36. doi: 10.1016/s0196-6553 (83) 80012-1.
27. Lo E, Nicolle L, Classen D et al. Strategies to prevent catheter-associated urinary tract infections in acute care hospitals. Infect Control Hosp Epidemiol 2008; 29: S41–S50.
28. Stéphan F, Sax H, Wachsmuth M et al. Reduction of urinary tract infection and antibiotic use after surgery: a controlled, prospective, before-after intervention study. Clin Infect Dis 2006; 42 (11): 1544–1551. doi: 10.1086/503837.
29. Dolin SJ, Cashman JN. Tolerability of acute postoperative pain management: nausea, vomiting, sedation, pruritis, and urinary retention. Evidence from published data. Br J Anaesth 2005; 95 (5): 584–591. doi: 10.1093/bja/aei227.
30. Gould CV, Umscheid CA, Agarwal RK et al. Guideline for prevention of catheter-associated urinary tract infections 2009. Infect Control Hosp Epidemiol 2010; 31 (4): 319–326. doi: 10.1086/651091.
31. Russell JA, Leming-Lee T‘, Watters R. Implementation of a nurse-driven CAUTI prevention algorithm. Nurs Clin North Am 2019; 54 (1): 81–96. doi: 10.1016/ j.cnur.2018.11.001.
32. Colborne M, Dahlke S. Nurses‘ perceptions and management of urinary incontinence in hospitalized older adults: an integrative review. J Gerontol Nurs 2017; 43 (10): 46–55. doi: 10.3928/00989134-20170515-02.
33. Cave CE. Evidence-based continence care: an integrative review. Rehabil Nurs 2017; 42 (6): 301–311. doi: 10.1002/rnj.291.
Štítky
Paediatric neurology Neurosurgery NeurologyČlánok vyšiel v časopise
Czech and Slovak Neurology and Neurosurgery
- Memantine Eases Daily Life for Patients and Caregivers
- Metamizole at a Glance and in Practice – Effective Non-Opioid Analgesic for All Ages
- Advances in the Treatment of Myasthenia Gravis on the Horizon
- Metamizole vs. Tramadol in Postoperative Analgesia
Najčítanejšie v tomto čísle
- Monitoring the prevalence of pressure ulcers – a comparison of national data with data of a specific health care provider – University Hospital Ostrava
- Nurses‘ knowledge in the field of specific prevention and treatment of heels pressure injuries
- Advanced practice nursing in the field of wound management
- Standardization of wound care for patients in Austria, Germany and Slovakia