对于老年患者及其直接护理人员来说，弄脏的护理垫的可接受等待更换时间是多久？

What Wait Time in a Soiled Pad Is Acceptable to Older Patients and Their Direct Caregivers?

作者信息

Fernando Judith, Wagg Adrian

机构信息

Judith Fernando, MD, Division of Geriatric Medicine, University of Alberta, Edmonton, Alberta, Canada. Adrian Wagg, MB FRCP (Lond), FRCP (Edin), FHEA, Division of Geriatric Medicine, University of Alberta, Edmonton, Alberta, Canada.

出版信息

J Wound Ostomy Continence Nurs. 2017 Nov/Dec;44(6):562-567. doi: 10.1097/WON.0000000000000369.

DOI:10.1097/WON.0000000000000369

PMID:28858968

Abstract

PURPOSE

We sought to establish views on wait times and hypothesized that they may vary depending upon perspective, circumstance, and incontinence type.

DESIGN

Cross-sectional, descriptive survey.

SUBJECTS AND SETTING

Eligible patients were inpatients, 65 years and older, in a single tertiary acute care hospital. Eligible staff were regulated (licensed) and unregulated providers of direct care to patients. Patients may or may not have used absorbent continence products prior to their admission.

METHODS

We examined views on acceptable and actual wait times of elderly acute care inpatients and their direct care providers (DCPs). Participants were asked about wait times for pads soiled with urine or feces during the day and at night. Differences between patients and DCPs and acceptable and actual wait times were compared. Factors associated with tolerance to the presence of urine or stool in absorptive products were analyzed by logistic regression.

RESULTS

There was patient-provider mismatch for daytime urinary incontinence: 90% of patients but only 44% of DCPs reported urinary soiling more than 1 hour in the daytime as unacceptable (38.0 vs 85.0 minutes; P < .0001). A significant majority (80%-90%) of both groups reported short acceptable wait times for fecal incontinence (<15 minutes). The odds of being tolerant to any soiling were significantly higher in patients who were prior residents of care facilities (odds ratio [OR] = 6.2; 95% confidence interval [CI], 1.3-28.1; P = .019), previously used incontinence products (OR = 2.0; 95% CI, 1.0-3.8; P = .036), or used walking aids (OR = 4.0; 95% CI, 1.1-14.7; P = .039). Actual wait times were significantly longer than deemed acceptable by either patients or DCPs.

CONCLUSIONS

There are significant gaps in patient-provider perspectives on acceptable wait times in soiled incontinence products. Direct care providers need to take patient preference into account when managing continence.

摘要

目的

我们试图确定关于等待时间的观点，并假设等待时间可能因视角、情况和失禁类型而异。

设计

横断面描述性调查。

研究对象与地点

符合条件的患者为一家三级急性护理医院的65岁及以上住院患者。符合条件的工作人员为受监管（有执照）和不受监管的直接护理患者的提供者。患者在入院前可能使用过也可能未使用过吸收性失禁产品。

方法

我们研究了老年急性护理住院患者及其直接护理提供者（DCP）对可接受等待时间和实际等待时间的看法。参与者被问及白天和晚上尿液或粪便弄脏尿垫后的等待时间。比较了患者与DCP之间以及可接受等待时间与实际等待时间之间的差异。通过逻辑回归分析与对吸收性产品中尿液或粪便存在的耐受性相关的因素。

结果

在白天尿失禁方面存在患者与提供者的认知差异：90%的患者但只有44%的DCP报告白天尿液弄脏超过1小时不可接受（38.0对85.0分钟；P<.0001）。两组中绝大多数（80%-90%）报告粪便失禁的可接受等待时间较短（<15分钟）。曾是护理机构居民的患者（优势比[OR]=6.2；95%置信区间[CI]，1.3-28.1；P=.019）、以前使用过失禁产品的患者（OR=2.0；95%CI，1.0-3.8；P=.036）或使用助行器的患者（OR=4.0；95%CI，1.1-14.7；P=.039）对任何弄脏情况的耐受几率显著更高。实际等待时间明显长于患者或DCP认为可接受的时间。