In 1995, the nursing staff of a 40 bed
skilled nursing unit, attached to a rural community
hospital, set up a program to lower costs of incontinence
management.
A gerontological clinical nurse
specialist was hired to help set up policies and
goals.
An interdisciplinary team, which
included LPNs and CNAs, carried out the program.
New I & O forms were used to
gather information.
An unexpected finding was the
borderline dehydration of the targeted
population.
An insulated water cooler was
placed in an area where residents had access.
The activities therapist offered
fluids at all activities.
Auxiliary staff and students were
all informed of the program.
Scheduled toileting was
instituted. For instance, patients were toileted
before and after ambulation.
Individual needs were addressed,
such as orthopedic patients needing bedside
commodes until they were more ambulatory.
Initially the committee met every
2 weeks to track and discuss progress.
The outcomes were favorable:
For example, one resident
decreased her episodes of incontinence
from 108 episodes in 2 weeks, to 30.
Her skin problems were
also resolved.
Another benefit from the
program was a 50% reduction in urinary
tract infections.
The program continues today. (From
report appearing in New Horizons (September/October
1996), written by Wierzbicki & Coren, an LPN
II and a CNA.
Instant Feedback:
Dehydration may be associated with urinary
incontinence in nursing home populations.