148 Urinary incontinence: a hospital inpatient point prevalence study

Abstract

Abstract Background Urinary incontinence is a common, although under-reported, problem in hospitalised older adults. One Irish study reported that 26% of hospitalised patients had urinary incontinence. Hospital-acquired urinary incontinence is associated with prolonged hospital stays, infection, poorer functional outcome, and poorer quality of life. We undertook a point prevalence study of all inpatients in a Level 3 hospital, as part of an audit focused on documentation and awareness of urinary incontinence. Methods Data were gathered on all inpatient at a single timepoint. The Emergency Department and Intensive Care Unit were excluded. Biographical data, admission diagnoses, diagnosis of dementia, delirium and urinary incontinence, use of diuretics and urinary incontinence medications, toileting plans, continence care bundles and mobility status were gathered from medical notes, nursing notes and drug Kardexes. Results The dataset compromised 309 patients. 11% were < 50 years old, 8% aged 50–59, 15% aged 60–69, 29% aged 70–79, 29% aged 80–89 and 8% were > 90 years old. 24% had a diagnosis of dementia, and 25% had delirium. Pre-admission continence status was known for 81% of patients; 8% catheterised, 12% incontinent, 12% had occasional accidents and 68% of patients were continent. At the time of data collection, 21% were catheterised. 14% incontinent, 18% had occasional accidents and 48% of patients were continent. 10% of patients were prescribed medications for urinary incontinence and 22% diuretics. 12% of patients with dementia were continent and 18% of patients with delirium. 40% of patients were independently mobile, 32% required assistance of one person, 17% assistance of two and 11% required a hoist. Dependent mobility was associated with increased rates of incontinence. Conclusion Our study found a high prevalence of urinary incontinence in hospitalised patients. Risk factors identified included older age, reduced mobility, long duration of admission, presence of dementia and or delirium and use of diuretics. These risk factors could be targeted as quality improvement initiative to promote continence in hospitalised patients,