Hospital care and urinary incontinence in the elderly

Abstract

Objective: to identify factors inherent in hospital care that favor urinary incontinence in the elderly. Method: an integrative review with Scopus, CINAHL and Pubmed searches. Includes original articles, no language restriction, published between 2008 and 2018. Rated level of recommendation and level of evidence were assessed using the Oxford Center for Evidence-Based Medicine classification. Exploited content through thematic analysis in light of the Donabedian model. Results: 13 articles constituted the sample. There were factors such as the unjustified and indiscriminate use of devices such as the geriatric diaper; hospital structure adversely affecting the needs of the elderly; and deficit in screening, risk identification and underreporting of the problem favor urinary incontinence in the hospitalized elderly. Conclusion: modifiable factors related to hospital structures and care processes favor both the onset and worsening of urinary incontinence in the elderly.

Construction and validation of an instrument for the structural assessment of wards for urinary continence in older adults

“…In this case, P: older adults; I: hospitalization; C: factors inherent to the care that predispose the event, and O: onset of UI. Thus, the following research question was formulated: What are the inherent factors to hospital care that predispose the onset of UI in older adults (4) ?…”

“…The UI problem is multifactorial and studies (3)(4) have revealed that the hospital structure and environment are extrinsic factors strongly related to its appearance or worsening. resources, information systems and technicaladministrative normative instruments up to political support and organizational conditions (5) .…”

“…During hospitalization, older adults find it difficult to maintain urinary continence due to structural problems that directly influence the encouragement of independence for the use of bathrooms. Among these, we highlight the deficit of human resources to assist in the mobilization of the person, the deficit of material resources such as wheelchairs and commode chairs, devices such as urinals and bedpans, in addition to architectural barriers such as the beds which are high and have bars, poor lighting in the corridors and absence of support bars and anti-slip floors, which causes insecurity for mobility due to the risk of falls (3)(4) .…”

“…The need for the use and maintenance of these devices must be assessed by nurses in the clinical practice from admission, as the installation may discourage independence with the use of bathrooms (4,8) .…”

“…It is an important function of the health team, especially nursing, to encourage the functional independence of the older adult, making themselves available to help them with mobilization or encouraging the use of urinals and bedpans, thus keeping the most favorable environment possible for maintaining their urinary continence (4,(7)(8) . In addition, the availability of human and material resources to assist in maintaining privacy and to encourage the independence and autonomy of the older adult at the time of eliminations is extremely important in the process of this care.…”