Incontinence brief use in acute hospitalized patients with no prior incontinence.

PURPOSE

The aim of the study was to evaluate the incidence of in-hospital incontinence brief use among older patients who did not use diapers prior to admission. A second aim was to identify factors affecting the use of incontinence briefs, commodes, urinals, and self-toileting.

SUBJECTS AND SETTING

The study was conducted in 5 medical acute-care units of a 900-bed teaching hospital in Israel. The data presented here were collected from a total of 465 patients (age ≥ 70 years) who did not use incontinence briefs prior to admission.

METHODS

The current study is part of a larger prospective cohort study conducted from February to November 2009. Patients or proxies were interviewed on admission regarding their functional status, mobility, continence status, and type of voiding patterns prior to hospital stay. Interviews regarding in-hospital voiding and mobility patterns were conducted each day after the first 48 hours of hospitalization. Electronic medical records were extracted to calculate the severity of illness, comorbidity score, and length of hospital stay.

RESULTS

The incidence of in-hospital adult incontinence brief use was 14% (65/465), whereas the rate of in-hospital commodes/urinals was 8.2% (38/465). The relative risk (RR) of incontinence brief use versus self-toileting was 18.76 (95% confidence intervals [CI]: 4.36-43.72) and 10.12 (95% CI: 2.23-13.48) higher for patients with low or moderate in-hospital mobility, respectively, versus those who were highly mobile. Patients who used incontinence briefs were more likely to be female (RR = 1.65; CI: 1.20-2.23) and were more likely to have low mobility (RR = 1.59; 95% CI: 1.10-2.35) than patients who used commodes/urinals.

CONCLUSIONS

Adult incontinence briefs are frequently used in continent patients, especially women, with low mobility. However, the current literature identifies incontinence briefs use as leading to multiple adverse outcomes. Therefore, the use of adult incontinence briefs among hospitalized older adults requires more scrutiny.