Incontinence management
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Modules - Incontinence Management
Individualizing Nighttime Incontinence Care in Nursing Home Residents.
John F. Schnelle, Patrice A. Cruise, Cathy A. Alessi, Nahla Al-Samarrai, Joseph G. Ouslander, 1998, in Nursing Research, 47(4):197-204.
An intervention that combined individualized nighttime incontinence care with a noise and light abatement program significantly reduced awakenings among 92 residents in four nursing homes. The intervention was developed in response to findings from an earlier nursing home study that found that 42% of nighttime waking episodes lasting four minutes or longer were associated with noise, light, or incontinence care activities.
For the intervention, incontinent residents were first assessed to determine their risk of developing skin problems. Nurses conducted hourly incontinence rounds and provided incontinence care only if a resident was found awake during the round. Residents at low risk for skin problems were allowed to sleep for as many as four consecutive hourly checks, but were awakened on the fifth if asleep. Residents at high risk for skin problems were allowed to sleep for only two consecutive hourly checks and awakened on the third if asleep.
The noise and light abatement program centered on common sense procedures such as closing doors to residents' rooms, fixing squeaky equipment, turning off unattended TVs and radios, and using table lamps instead of overhead lights when providing incontinence care. There were no adverse, intervention-related changes in skin health or most other risk factors associated with skin. The intervention also proved no more labor intensive to provide than usual care.
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