Barakat-Johnson M, Barnett C, Lai M, Wand T, White K, et al.
Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy an.... Date of publication 2018 Jul 1;volume 45(4):349-355.
1. J Wound Ostomy Continence Nurs. 2018 Jul/Aug;45(4):349-355. doi:
10.1097/WON.0000000000000446.
Incontinence, Incontinence-Associated Dermatitis, and Pressure Injuries in a
Health District in Australia: A Mixed-Methods Study.
Barakat-Johnson M(1), Barnett C, Lai M, Wand T, White K.
Author information:
(1)Michelle Barakat-Johnson, PhD, MN, RN, Sydney Local Health District, and the
Faculty of Health and Medicine, The University of Sydney, Camperdown, Australia.
Catherine Barnett, PhD, Cancer Nursing Research Unit, Faculty of Health and
Medicine, The University of Sydney, Camperdown, Australia. Michelle Lai, MRes,
Cancer Nursing Research Unit, Faculty of Health and Medicine, The University of
Sydney, Camperdown, Australia. Timothy Wand, PhD, MN(Hons), RN, NP, The
University of Sydney and Sydney Local Health District, Emergency Department,
Royal Prince Alfred Hospital, Camperdown, Australia. Kathryn White, PhD, MN, RN,
Cancer Nursing Research Unit, Faculty of Medicine and Health, The University of
Sydney, Camperdown, Australia.
PURPOSE: This purpose of this study was to measure the prevalence of
incontinence, incontinence-associated dermatitis (IAD), and pressure injuries
(PIs) in a local health district in Australia. We also aimed to determine
associated evidence-into-practice gaps.
DESIGN: Multisite mixed-methods study.
SUBJECTS AND SETTINGS: The sample comprised 250 adult patients in 12 units
across 4 hospitals; their mean age was 73 years. Nurses caring for the patient
at the time of the audit were questioned on nursing practice for patients with
incontinence.
METHODS: A 2-page audit tool was developed and used to capture demographic data,
continence and mobility status, IAD and PI, incontinence products, nursing
practice observations, and nurses' comments. Each patient was assessed by 2
senior nurses. Quantitative analysis included descriptive statistics and
bivariate analysis using a χ test to examine the association between mobility
and incontinence and a Fisher exact test to examine the association between IAD
and PI. Content analysis was used to analyze qualitative data and develop
themes.
RESULTS: Almost half of patients had incontinence (n = 111/250), 20.7% of
patients with incontinence (n = 23/111) had IAD, and 6.3% (n = 7/111) had
hospital-acquired PI. There was a significant association between incontinence
and mobility, and between IAD and PIs. In addition, 22.3% of patients who were
continent (31/139) were wearing an incontinence product. Analysis of qualitative
data found that both incontinence management and language used to refer to
incontinence pads were incompatible with current best practices.
CONCLUSION: The prevalence of incontinence among patients observed in this study
was similar to rates reported internationally, but the prevalence of IAD was
slightly lower. The association between IAD and PIs, as well as incontinence and
mobility, was statistically and clinically significant. Nurses commonly used
interventions with little or no evidence. Hospitals should put measures in place
to improve nurses' knowledge of incontinence, IAD, and PI practices.
DOI: 10.1097/WON.0000000000000446
PMID: 29994863 [Indexed for MEDLINE]
