Inertia in nursing care of hospitalised patients with urinary incontinence

Artero-López, Consuelo; Márquez-Hernández, Verónica V.; Estevez-Morales, María Teresa; Gámez, Genoveva Granados

doi:10.1111/jocn.14289

Cited by 14 publications

(25 citation statements)

References 38 publications

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“…the use of UI pads and pants) continues to be portrayed in the international research literature as the nursing norm for UI care in the primary care context rather than curing, controlling or proactively managing the symptoms (Booth et al, ; McCarthy, McCormack, Coffey, Wright, & Slater, ; Shaw & Wagg, ). Inertia was seen to exist among nurses towards treating UI in a hospital context, and a pattern of “severely compromised actions” (Artero‐Lopez, Marquez‐Hernandez, Estevez‐Morales, & Granados‐Gamez, , p. 1,488) was identified in relation to the management of UI; for example, rating scales were not used, and information on the type of UI, general recommendations and recommended aids was not documented. Thus, limited RN engagement in continence care and not facilitating suitable interventions results in suboptimal, poorly managed continence care.…”

Section: Introductionmentioning

confidence: 99%

Registered nurse’s experiences of continence care for older people: A qualitative descriptive study

Borglin

Thach²,

Jeppsson

et al. 2019

Int J Older People Nursing

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Aim This study aimed to illuminate nurses’ experience of continence care for older people receiving home care, either in their own home or in an assisted living facility. Background Registered Nurses (RNs) have a major role to play in identifying and establishing appropriate actions regarding continence care for older people. However, the crucial nursing care pathway for continence care is commonly described as poor. Methods Interviews were conducted with 11 RNs providing home care, and the transcribed texts were analysed using inductive content analysis. Result The impressions of RNs were categorised according to four themes: perceptions of continence care, an open approach to continence care, the need for personalised aid fittings and the importance of teamwork in continence care. Key findings were the importance of teamwork; the need for nurses to embrace leadership at the point of care and be more visible in terms of the provision of direct care; substantiation that evidence‐based interventions, such as scheduled toileting and prompted voiding, should constitute the norm in continence care within the context of home care; and the need for nurses to support the right of older persons to receive an assessment of their continence problems, deemed to be the minimum standard of quality care. Conclusion The provision of continence care that is based on key nursing standards, such as evidence‐based and person‐centred care, as well as individualised continence care that is based on evidenced‐based guidelines, would ensure an improvement in the continence care that is presently on offer to older people. Implications for practice Nurses need to embrace leadership at the point of care and to be more visible with the provision of direct care in order to improve continence care for older people receiving home care.

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Section: Introductionmentioning

confidence: 99%

Registered nurse’s experiences of continence care for older people: A qualitative descriptive study

Borglin

Thach²,

Jeppsson

et al. 2019

Int J Older People Nursing

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“…21 A study on acute care nursing noted what the authors called inertia in continence care, where in 600 records from 132 nurses, there was little documentation of assessment or diagnosis of UI in hospital inpatients. 24 Factors related to the suboptimal provision of continence care by nursing staff have been examined in a number of studies using a variety of methods; these can be classified into personal (eg, attitude, belief, lack of content knowledge), team-based (eg, low priority, low commitment) and organizational (eg, high workload, limited access to required resources, lack of institutional support) factors. 22,25,26 Nurses in practice appear to be deficient in knowledge on how to deal with UI, with their care focusing on containment.…”

Section: What Limits Nursing Engagement In Continence Promotion and Cmentioning

confidence: 99%

Improving nurse engagement in continence care

Hunter¹,

Wagg²

2018

NRR

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Urinary (UI) and fecal incontinence (FI) are troublesome conditions for many in society; both UI and FI increase in prevalence with increasing age. Despite well-recognized effects on health, well-being and quality of life, incontinence is often seen by care providers and payers as a social problem, rather than a health related one. Nurses are in a key position to assist those affected by UI. Nurses have the potential to identify people with incontinence, establish appropriate interventions and provide valuable education to empower patients. Indeed, nurses are ideally placed to perform the initial assessment and management of incontinence, that portion of the care pathway which is crucial, but often poorly done. Unfortunately, this is not always easily implemented; nursing staff have identified environmental barriers, such as lack of time at work, and consider UI a low priority that prevents the facilitation of interventions. This article reviews the evidence on nursing involvement, or lack of it, in continence care and suggests a strategy to improve the situation, involving a complex intervention of knowledge translation. The problem and its current stateConstituting one of the more common features of later life, urinary (UI) and fecal incontinence (FI) are troublesome conditions for many in society; both UI and FI increase in prevalence with increasing age. 1,2 Current prevalence estimates suggest that UI affects the lives of an estimated 400 million persons worldwide. 3 The prevalence of FI among community-dwelling US adults was recently estimated at 8.39%, with FI being more common in women when they also had UI. 2 Despite well-recognized effects on health, well-being and quality of life, incontinence is often seen as more of a social problem by care providers and payers, rather than a health-related problem.Published data reveal that the proportion of persons with UI who express a felt need for care is far below the proportion of people with the condition; the same is also true for FI. Incontinence is a stigmatized condition; people with the problem go to great lengths to hide their incontinence from others, adopt changes in lifestyle to accommodate to a new "normal" existence and delay seeking appropriate help. In fact, symptom severity and the extent to which the symptoms become "disabling" appear to precipitate health care seeking. Lagace et al found that 72.0% of those currently afflicted with UI had not spoken to physicians about the problem, whereas 37.0% indicated that they would have sought care if they had been aware of the available tests and effective treatments. 4

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“…Little attention has focused on hospital UI care until recently. Artero-López and colleagues2 investigated the role clinical inertia (defined for this study as, ‘any action inherent to care, as a relationship of ineffective assistance between the nurse and the patient’) played in hospitalised adults.…”

Section: Contextmentioning

confidence: 99%

“…Artero-López and colleagues2 used an innovative approach to better understand UI care in hospitalised adults. Clinical inertia is new to nursing and relatively new to medicine.…”

Section: Commentarymentioning

confidence: 99%

There is a lack of preventive care and treatment interventions for urinary incontinence in hospitalised adults

Palmer

2018

Evid Based Nurs

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Inertia in nursing care of hospitalised patients with urinary incontinence

Abstract: Contributing to the understanding of the existence of inertia in nursing care raises questions regarding its causes and interventions to predict or monitor it.

Cited by 14 publications

References 38 publications

Registered nurse’s experiences of continence care for older people: A qualitative descriptive study

Registered nurse’s experiences of continence care for older people: A qualitative descriptive study

Improving nurse engagement in continence care

There is a lack of preventive care and treatment interventions for urinary incontinence in hospitalised adults

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