Nurse and Health Care Aide Knowledge of Urinary Continence Promotion and Management In Hospitalized Older People

Determinants of Bladder Care at Night in a Subacute Ward for Aged Patients: An Observational Study

PURPOSE

The purpose of this study was to evaluate how bladder care at night correlates to patients' mobility status.

DESIGN

This was an observational study.

SUBJECTS AND SETTING

The sample comprises 63 aged care subacute patients who were observed over 3 consecutive nights in an inpatient subacute aged care ward located in Melbourne, Australia. Half of the participants were female; their mean age was 82.0 (standard deviation 8.2) years. Data were collected from December 2020 to March 2021.

METHODS

Outcome variables included demographic and pertinent clinical characteristics, type and timing of toileting and/or bladder care provided, and mobility classification. Descriptive statistics were used to summarize the frequency of nocturnal bladder care provided each night and as a mean over the 3 nights. The relationship between the type of care units provided and other variables was explored using a 1-way analysis of variance; values ≤.05 were deemed statistically significant.

RESULTS

Findings indicate that 27% (n = 17), 41% (n = 26), and 48% (n = 30) of participants required assistance to move in bed, sit up in bed, and stand from sitting, respectively. Care episodes for both incontinence and assistance with voiding were significantly associated with functional mobility in bed ( F = 5.52, P < .001; F = 2.14, P = .02) and with ambulation independence ( F = 3.52, P = .001; F = 2.04, P = .03) but not with age or ambulation distance.

CONCLUSIONS

Care provided for urinary incontinence during the night was related to the need for physical support of ambulation and poor mobility in bed. Targeted input from a multidisciplinary team is warranted to facilitate change of practice at night.

Perceptions of primary health care nurses and general practitioners in the care of older people with urinary incontinence

AIMS

To identify the challenges and opportunities among primary health care nurses and general practitioners (GPs) in the care of older people with urinary incontinence (UI) and other chronic conditions in China.

BACKGROUND

UI is highly prevalent among community-dwelling older people with chronic conditions but is underreported and poorly managed. Understanding the factors that affect primary health care professionals' practices in their care for this population is imperative to foster nurse-led UI care services.

DESIGN

A qualitative descriptive study.

METHODS

Four focus groups were held with 24 primary health care nurses and GPs in Changsha, Hunan Province, China, between July and September 2021. A reflective thematic analysis was used to identify themes.

RESULTS

This study revealed misconceptions regarding older people living with UI and other chronic conditions in primary care health professional participants. Moreover, primary health care nurses had very limited autonomy in UI diagnosis and initiating care interventions for this patient population. By reflecting on practices, participants recognized various practical solutions to improve the detection and management of UI. Participants also identified barriers to accessing care services in older people with UI. They suggested changes in the health care system to achieve universal access to UI care services for older people.

CONCLUSION

Nurse-led UI care services in primary health care for community-dwelling older people with chronic conditions are in high demand but are underdeveloped due to professional and health care system factors.

IMPACT

Findings from this study provide new insights into challenges faced by primary health care professionals and illuminate practical solutions to address these challenges.

REPORTING METHODS

Adherence to COREQ guidelines was maintained.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Patients' experiences of urinary retention and bladder care - A qualitative study in orthopaedic care

BACKGROUND

Urinary retention is a common complication associated with hip surgery. There are easily available, evidence-based clinical practice guidelines prescribing how to prevent both urinary retention and other voiding issues, by means of bladder monitoring and risk assessments. A detected lack of adherence to such guidelines increases risks for unnecessary suffering among patients but a greater understanding of patients' experiences can benefit tailored interventions to address quality and safety gaps in orthopaedic nursing and rehabilitation.

PURPOSE

The aim was to describe patients' experiences of urinary retention, bladder issues, and bladder care in orthopaedic care due to hip surgery.

METHOD

This was a qualitative study with a descriptive design: content analysis with an inductive approach was applied to interviews (n = 32) and survey free-text responses (n = 122) across 17 orthopaedic units in Sweden.

RESULTS

The patients had received no or limited details for the recurrent bladder care interventions (such as bladder scans and prompted voiding) while at the hospital. They relied on the staff for safe procedures but were left to themselves to manage and comprehend prevailing bladder issues. Despite the patients' experiences of bladder issues or the risk of urinary retention postoperatively, the link to hip surgery remained unknown to the patients, leaving them searching for self-management strategies and further care.

CONCLUSIONS

Patients' perspectives on bladder care, urinary retention and bladder issues can serve as a means for increased understanding of procedures and issues, reinforcing improved implementation of guidelines, including person-centred information. Safer bladder procedures imply further patient engagement, highlighted in guidelines.

Nursing assistants' knowledge, attitudes and training needs regarding urinary incontinence in nursing homes: a mixed-methods study

BACKGROUND

Urinary incontinence is an increasingly common problem, especially among older people in nursing homes. Nursing assistants are the leading workforce in nursing homes, and their knowledge and attitudes regarding urinary incontinence have garnered considerable attention in the context of aging in China. However, most previous studies on this issue have focused on registered nurses. This study aimed to explore nursing assistants' knowledge, attitudes and training needs with regard to urinary incontinence.

METHODS

We conducted a two-part mixed-methods study. After institutional manager approval, we surveyed the knowledge and attitudes of 509 nursing assistants regarding urinary incontinence. We carried out semi-structured interviews with 40 nursing assistants to elicit detailed information on training needs.

RESULTS

In general, knowledge about urinary incontinence was poor (14.00 ± 4.18), although attitudes were primarily positive (35.51 ± 3.19). Most nursing assistants were very willing to learn more about urinary incontinence (93.9%, 478/509), but time constraints and low educational background may be barriers to learning motivation. The three preferred training styles among nursing assistants were face-to-face guidance from a mentor, training combining theory with practice, and online video training.

CONCLUSIONS

Chinese nursing assistants had poor knowledge but positive attitudes toward urinary incontinence. Facility managers should focus on developing training and learning mechanisms regarding urinary incontinence. It is important to adopt diverse training styles according to the actual situation of nursing homes.

E-learning modules to enhance student nurses' perceptions of older people: a single group pre-post quasi-experimental study

OBJECTIVES

To examine whether e-learning activities on cognitive impairment (CI), continence and mobility (CM) and understanding and communication (UC) improve student nurses' knowledge and attitudes in the care of older adults.

METHODS

A quasi-experimental single group pre-post-test design was used. We included 299 undergraduate nursing students for the CI module, 304 for the CM module, and 313 for the UC module. We administered knowledge quizzes, Likert scales, and a feedback survey to measure student nurses' knowledge, ageist beliefs, and feedback on the modules respectively.

RESULTS

Participants demonstrated significantly more knowledge and reduced ageist attitudes following the e-learning activities.

CONCLUSIONS

Findings suggest that e-learning activities on cognitive impairment, continence and mobility, and understanding and communication improve knowledge and reduce ageist attitudes among nursing students.

Improving practicing nurses' knowledge of the cognitive impairment, continence, and mobility needs of older people

OBJECTIVES

To test if two e-learning modules - one on cognitive impairment, and one on continence and mobility - in older people would improve the knowledge of nurse members from the Canadian Gerontological Nurses Association and College of Licensed Practical Nurses of Alberta.

METHODS

A pre-post-test design was used to test 88 nurses' knowledge of cognitive impairment and 105 nurses' knowledge of continence and mobility and their perceptions of how the modules contributed to their learning.

RESULTS

There was a statistically significant increase in practicing nurses' knowledge about cognitive impairment (0.68 increase), continence (2.30 increase), and its relationship to mobility. Nurses' self-report on the feedback survey demonstrated increases in knowledge, confidence, and perceptions about older people.

CONCLUSION

These results suggest the modules have strong potential to enhance practicing nurses' knowledge about cognitive impairment, continence, and mobility.

Factors Influencing Nursing Students' Knowledge of and Attitudes Toward Urinary Incontinence

PURPOSE

This study aimed to determine nursing students' knowledge about and attitudes toward patients with urinary incontinence.

SUBJECTS AND SETTING

The sample comprised 392 nursing students from 5 educational institutions in Hong Kong; all participants were enrolled in year 4 or 5 of their undergraduate nursing program, and all had completed formal education on urinary incontinence and clinical experience caring for patients with urinary incontinence.

METHODS

A cross-sectional survey was conducted in February 2017. Participants completed a 55-item questionnaire that included items querying demographic and pertinent professional background information, along with 2 validated instruments: the Urinary Incontinence Knowledge Scale (UIKS) and the Urinary Incontinence Attitude Scale (UIAS). Analysis of variance was performed to compare the differences in scores among nursing students based on demographic or educational background. Pearson's correlation coefficient or χ2 was used to examine the relationships between variables and multivariate regression analyses were performed to identify the predictors of attitude toward urinary incontinence.

RESULTS

Urinary incontinence knowledge was moderate (mean 22.0/30, SD 4.4) and attitudes about urinary incontinence were positive (mean 41.6/60, SD 4.5). There was a significant correlation between attitudes and knowledge (r = 0.175, P = .001), institution at which the students received training (χ2 = 161.790, P = .000), and the experience of having taken a course that included instruction about urinary incontinence (χ2 = 37.707, P = .014). Regression analysis revealed that knowledge and institution were predictors of attitudes. Participants reported high level of interest in learning more about urinary incontinence (71.2%).

CONCLUSIONS

Nursing students residing in Hong Kong have a moderate level of knowledge and positive attitude toward urinary incontinence. This study suggests that educational institution and specific instruction about urinary incontinence play key roles in developing positive attitudes toward caring for patients with urinary incontinence.