Urinary incontinence (UI) associated with overactive bladder is a considerable burden on long-term care residents and staff, according to a survey of nursing directors.
Richard G. Stefanacci, DO, Thomas Jefferson University, Philadelphia and Journal of Gerontological Nursing .
CNA performs most UI product changes and spends 56.4% of its time managing UI requirements, according to the poll. UI products are checked for moisture every 2.5 hours, and 5.6% of respondents said employees always change UI products, even when residents are dry.
In addition, CNA replaced an average of 36.6 UI products and assisted with an average of 25.5 toilet visits per shift, taking 12.1 minutes and 12.9 minutes, respectively, per group. Staff also changed sheets an average of 1.7 times per shift due to wetting incidents.
“Especially with COVID, we’ve taken our attention off the ball a bit — especially with staff burdens,” Stefanacci told MedPage Today . “Our nursing staff – CNAs and nurses – are incredibly exhausted. The opportunity to see overactive bladder and understand its negative impact on residents and staff should resonate with management.”
“They need to have key leaders in the facility who understand and understand that this is a priority – and have systems in place to determine who is the right patient, what the right course of action is, and can The right people to help,” he added.
According to survey respondents, 62% of long-term care facility residents have experienced UI and 40% are consistently incontinent. Responses suggest that UI has a particular impact on long-term quality care for urinary tract infections (UTIs) and falls.
For example, 55% said they believed UI was a major or important cause of urinary tract infections. They also noted that 26.3% of rashes and 30.9% of skin infections caused by diaper rash required treatment, and 10.4% of rashes or infections led to antibiotics.
In addition, they reported that residents fell an average of 14.3 times a month, a third of which occurred while residents were trying to go to the bathroom.
Stefanacci and colleagues found that the survey revealed a “treatment gap” in UI drugs. Despite its prevalence, nursing directors report that only 14.5 percent of patients are currently being treated with UI or overactive bladder medication, a percentage that Stefanacci called “disappointing.”
The survey also revealed that 75% of nursing executives said they were unaware that anticholinergic drugs—“the backbone of overactive bladder treatment”—are associated with risk of cognitive side effects relationship between. Additionally, while about two-thirds of respondents said they tracked treatment response either subjectively or quantified/documented, 22.5% had no process to formally assess improvement at all.
UI also results in a significant financial burden on the facility under investigation. The UI product costs an average of $5,407 per month and costs more when purchased at the facility level rather than the chain level. Monthly cleaning costs were similarly high at $5,497, with slightly higher costs at the facility level than at the chain level. In addition, 53.5% of the respondents indicated that the cost of UI products is higher or higher than other consumables.
The survey consisted of 70 questions divided into six sections, including background screening, facility characteristics, UI and residency care, UI product cost and burden, UI impact on CMS quality measures, and UI therapy.
The majority (64.8%) of the facilities included in the survey were part of a chain, with an average of 115.3 residents. Facilities have an average of 68.3% female residents, 45.9% with mild cognitive impairment, and 45.6% with dementia or Alzheimer’s disease.
Mike Bassett is a staff writer specializing in oncology and hematology. He lives in Massachusetts.
Urovant Sciences contracted IQVIA to design and perform the study and participated in data analysis and manuscript preparation.
Stefanacci is a consultant to Urovant Sciences.
Other co-authors report employment or consulting roles at Urovant Sciences and IQVIA.