Identifying reasons, gaps and prevalence of diaper usage in an acute hospital

Abstract

Are diaper usage overused in acute hospital settings? Are there ways to avoid unnecessary diaper usage? This study aimed to identify the prevalence of diaper usage and the reasons of using diaper as well as to suggest strategies to avoid unnecessary use of diaper. Diaper is widely used for patients in hospitals worldwide but is seldom to be report its prevalence. Some patients with medical issues need to use diaper but some who do not have those problems are still given a diaper to wear once admitted. This is a cross‐sectional prevalence survey study from 24 wards covering 3 major departments between 19 and 26 October 2016. Data were sourced from different means such as documents and interviewing patients/relative, nursing and nursing supporting staff. The study was approved by cluster general manager (nursing) who supported the study to improve patient care. The overall prevalence rate of diaper usage during admission was 37·9%. The top four reasons of diaper usage in all departments were faecal/urinary incontinence, poor patient condition, confusion and poor mobilization which accounted for 38, 15, 10 and 8% respectively. A total of 53 patients of those who had not used diapers before admission but were given diapers to wear, reported reasons as having poor mobilization and lower limb weakness. This is the first study ever to explore the prevalence and reasons of diaper usage in Hong Kong. Different reasons to use diapers after admission but patients did not use diaper upon admission could be identified in various department. A clinical guideline on proper use of diaper that identified some gaps of the prevailing practice and possible solutions was suggested to improve clinical practice.

Catching a resurgence: Increase in SARS-CoV-2 viral RNA identified in wastewater 48 h before COVID-19 clinical tests and 96 h before hospitalizations

“…It is noted that several current studies investigating fecal shedding timelines and intensity for SARS-CoV-2 may in fact be investigating the sickest of patients in a hospital setting ( Chen et al, 2020 ; Fontana et al, 2020 ), and so patterns may not reflect occurrences in the general population, where a significant quantity of patients will likely suffer from milder symptoms, or no symptoms at all ( Pan et al, 2020 ; Park et al, 2020 ). Furthermore, sicker or elderly patients may in fact “fall off” the wastewater monitoring efforts if bed pans or adult diapers are utilized as part of their treatment and convalescence in a hospital or retirement home ( Coelho et al, 2015 ; Tsang et al, 2017 ).…”

Absorbent incontinence pad use and the association with urinary tract infection and frailty: A retrospective cohort study

“…It is not protocol to document this, and the reasons would not be found in the journals. However, other studies have shown that impaired cognitive capacity, low physical functional status, and incontinence at admission are reasons for becoming a user of incontinence pads during hospitalization ( Tsang et al., 2017 ; Zisberg, 2011 ; Zisberg et al., 2011 ). However, in several studies, unnecessary use of incontinence pads during hospitalization has also been found.…”

“…Likely, several of the older patients in our study did not have a reason either. In other studies it has been pointed out that national guidelines might reduce the unnecessary use of absorbent incontinence pads and, thereby, urinary tract infections ( Bitencourt et al., 2018 ; Tsang et al., 2017 ). However, despite national guidelines regarding the use of absorbent incontinence pads in Denmark, we have found results comparable to those mentioned above ( Houlind and Klarskov, 2019 ).…”

“…Urinary incontinence is: “[…] the complaint of any involuntary leakage of urine ” and can be categorized as continuous urinary incontinence if there are “ […] complaints of continuous leakage” ( Abrams et al., 2003 ). Researchers have emphasized the lack of evidence-based research in this field ( Condon et al., 2021 ; Melo et al., 2017 ; Tsang et al., 2017 ).…”