Background Incontinence is a common and troublesome feature of frailty (NCPOP 2012), routinely examined in a comprehensive geriatric assessment (CGA). It can impact on life quality, mobility, falls and overall care needs. Patients often develop incontinence during hospital admission and staff knowledge of continence status (CS) and efforts to drive improvements are often poor. We sought to explore these issues on our wards. Methods We conducted a point prevalence study, reviewed medical charts and interviewed ward nurses on three specialist geriatric wards. Patients >65y over a six-week period were included. We developed a proforma and recorded current and pre-admission CS, and use of continence wear. Nursing staff awareness of CS was also explored. Results 104 patients (57% female, mean age 81y) were included. Overall, 34 (32.7%) had urinary incontinence (UI), of whom 22 (64%) developed new UI since admission. 27 (25.7%) patients had a urinary catheter inserted, most (23; 85%) for short-term use. Almost half (46; 44.2%) had faecal incontinence (FI), of which 74% was new FI since admission. Overall, 19 patients (18%) were doubly incontinent. Continence wear was also reviewed; 57 (54%) were in full wrap-around continence wear, 28 (27%) in pull-ups. 26 (25%) wore continence wear despite being continent. Only 28 (27%) had a call bell within reach. Nursing awareness was examined, 85 nurses (81.7%) were aware of their patient’s CS, and 15 (14.4%) were partially aware. In all cases, nursing handover documents were consulted. For 35 patients, (33%) CS impacted on their discharge plan. Conclusion Rates of UI and FI were high in our cohort and further increased during hospital admission. Staff knowledge was satisfactory but suboptimal efforts were made to improve CS. Consequently, an education session was delivered to clinical staff to embed continence assessment into CGA. Additionally, continence advocates have been appointed to each ward.

中文翻译：

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老年专科病房患者节制及相关工作人员知识回顾


背景 失禁是一种常见且麻烦的衰弱特征（NCPOP 2012），在综合老年评估（CGA）中进行常规检查。它会影响生活质量、行动能力、跌倒和整体护理需求。患者在入院期间经常出现失禁，而工作人员对失禁状态 (CS) 的了解和推动改善的努力往往很差。我们试图在我们的病房探讨这些问题。方法 我们进行了点患病率研究，查阅了病历并采访了三个老年专科病房的病房护士。六周内 >65y 的患者被纳入其中。我们制定了一份形式并记录了当前和入院前的 CS 以及失禁穿戴的使用情况。还探讨了护理人员的 CS 意识。结果 纳入 104 名患者（57% 为女性，平均年龄 81 岁）。总体而言，34 名患者（32.7%）患有尿失禁（UI），其中 22 名患者（64%）自入院以来出现了新的尿失禁。 27 名（25.7%）患者插入了导尿管，其中大多数（23 名；85%）是短期使用。近一半（46；44.2%）有大便失禁（FI），其中 74% 是入院以来新出现的大便失禁。总体而言，19 名患者 (18%) 患有双重失禁。还对失禁穿着进行了审查； 57 人 (54%) 穿着全包裹式节制服装，28 人 (27%) 穿着引体向上。 26 人 (25%) 尽管能够节制，但仍然穿着节制服。只有 28 名 (27%) 的人手边有呼叫铃。对护理意识进行了检查，85 名护士（81.7%）了解患者的 CS，15 名护士（14.4%）部分了解。在所有情况下，都查阅了护理交接文件。对于 35 名患者 (33%)，CS 影响了他们的出院计划。结论 我们的队列中 UI 和 FI 发生率较高，并且在入院期间进一步增加。员工知识令人满意，但在提高 CS 方面的努力不够理想。 因此，我们向临床工作人员举办了一次教育课程，将节制评估纳入 CGA。此外，每个病房都任命了节制倡导者。