Authors (including presenting author) :
Ng SL (1), YU KY(2), Lee, I (3)
Affiliation :
(1) Urology Nurse Consultant, Department of Surgery, Queen Mary Hospital, HongKong. (2) Department Operations Manager, Intensive Care Unit , Queen Mary Hospital, Hong Kong. (3) Ex Cluster General Manager (Nursing), Hong Kong West Cluster, Hong Kong.
Introduction :
Incontinence of urine and bowel are not uncommon conditions found in older people. In the past, it was accepted that incontinence and old age necessarily went together; now it is recognized that incontinence is a health issue that can be prevented and managed. Kadir FS (2004) mentioned that there was unjustified overuse of adult diapers in hospital settings.
Apparently, the application of diapers on elderly is not a treatment of urinary and or bowel incontinence. Studies have clearly shown that the use of adult diapers has been linked to deleterious effects such as pressure ulcers, recurrent urinary tract infections, depression and functional dependency.
Objectives :
Several studies reported that nursing staff has a lack of knowledge on incontinence care. Thus, a survey on prevalence and current practice of adult in-patients' diaper application in our clinical area is crucial to determine nursing staff's knowledge and attitude on incontinence care.
Methodology :
A survey was conducted in all adult-in-patient wards of Queen Mary Hospital on 4 May 2017. Inclusion criteria include all wards in medicine, surgery, neurosurgery, orthopedics & traumatology, gynecology, oncology, adult intensive care unit and cardiothoracic surgical unit. Exclusion criteria include outpatient clinics, operation theatre, day centre, obstetrics, pediatric and accident & emergency department.
A simple and precise questionnaire was sent to the ward in-charge one day before the survey started. The ward in-charge was required to complete the questionnaire including the total number of patients in ward and the number of patients required diaper application with reasons behind at the moment we conducted the survey.
All completed surveys were returned to Central Nursing Division for data analysis.
Result & Outcome :
1,133 adult patients were admitted in adult wards of Queen Mary Hospital on 4 May 2017. There were 355 patients accounted for 31.33% had diaper application during hospitalization. Among 31.33 % adult in-patients had diaper application, only 123 patients accounted for 34.65% of them really required diaper application due to incontinence and unconscious. We found that more than 20% of adult in-patients on diaper just because of mobility and aging problems. Also, there were 23% of in-patients had diaper application without any reason documented. Incontinence, as we known, is a health issue that can be treatable and manageable in many cases. From the survey conducted in our hospital, we found that majority of the adult in-patients (65.35%) actually not required diaper application. The misusage of diapers on patients not only affect the quality of care to patients, but also increase the cost and financial burden on hospital. Thus, nursing staff's knowledge and attitudes on incontinence care are crucial to implement the standard of care effectively and avoid unnecessary usage of diapers in hospital.
