Management of Urinary Incontinence in Veterans Administration Nursing Homes

Abstract

Nursing Home Care Units in Veterans Administration Medical Centers across the country were surveyed to determine methods of management of urinary incontinence (UI) in the nursing home (NH) setting. Information was obtained from 90 of the VA NHs on demographic aspects of the NH population, prevalence and severity of urinary and fecal incontinence, common problems encountered, and specific strategies and techniques. Written guidelines for bladder training and catheter care from many of the NHs were analyzed. The results of the survey reinforce the need for research designed to improve the care of the incontinent NH patient.

Potentially inappropriate urinary catheter indwelling among long‐term care facilities residents

“…Ouslander and Fowler reported that 50–75% urinary incontinent patients also experience fecal incontinence in the same time [17], which was similar in this study that 82.2% of long‐term UC indwelled subjects were constipated. Fecal incontinence is a well‐known contributing factor to urinary incontinence, and aggressive management is beneficial to reduce urinary symptoms.…”

Use of Urinary Collection Devices in Skilled Nursing Facilities in Five States

“…20 Reports of the prevalence of urinary catheterization in the 1980s varied considerably, from 7.5% to 22%. [21][22][23][24] A study of nursing home residents in Virginia found a decrease in urinary catheterization from 15.2% before the Omnibus Budget and Reconciliation Act to 4.8% after implementation of this act. 25 These data suggest that the implementation of regulations to improve the quality of care regarding catheterization may have affected clinical practice, although improvement could be directed to hospitals that transfer patients into the nursing home setting; there continues to be a high prevalence of catheterization at the time of admission to the SNF.…”

Urinary Catheters: What Type Do Men and Their Nurses Prefer?

“…Indwelling and condom catheters are often used to collect urine in men with urinary incontinence 13–15 . The relative merits of and problems with these catheters have not been well studied.…”