Pyuria detection using a dipstick applied to urine in incontinence pads

The purpose of this study was to determine whether pressing a dipstick into a pad within 2 hours of urine saturation detected pyuria as effectively as immersing a dipstick in a urine specimen. Sensitivity, specificity, and positive and negative predictive values indicated that results of the pad method were as effective as those of direct dipstick into clean-catch urine in detecting pyuria. In the elderly, sensitivity of the pad method was 100%, indicating this would be an effective method for initial assessment of pyuria.     

Bacteriuria and urinary incontinence in aged female nursing home residents

Although urinary incontinence (UI) is identified as a symptom of urinary tract infection (UTI), the incontinent elderly frequently are not treated for UTI unless clinically significant manifestations are present. The purpose of this research was to identify variables that may be associated with bacteriuria in the female person who is already known to be incontinent. A sample of 65 incontinent female nursing home residents was divided into three groups: (1) those with negative urine screens; (2) those with a bacterial count of over 100,000 per ml of urine; and (3) those with a bacterial count of below 100,000 per ml urine. Variables examined were: (1) physical symptoms; (2) physical examination findings; (3) mental status; and (4) functional abilities. Significant group differences were found regarding awareness of the urge to void and ability to hold urine. A near significance finding suggested that the higher the level of cognitive function the less likely the presence of UTI. There was some evidence to suggest the higher the level of independence the less likely the presence of UTI. Recommendations for nursing practice and future nursing research are made.     

Urinary incontinence: nursing home staff reaction toward residents

1. ISQ-SR is a reliable and valid tool to measure psychological stress associated with working with urinary incontinent patients. 2. ISQ-SR can be used to measure efficacy of continuing education programs aimed at reducing staff stress associated with urinary incontinence. 3. Eighty percent of the staff reported that they looked for ways to help patients with their incontinence all the time, but only 50% said that they felt comfortable working with urinary incontinent patients all of the time. 4. Sixty-three percent of the staff reported that they felt frustrated about working with urinary incontinence some of the time, indicating a need for continuing education.     

Urinary incontinence in nursing home residents with dementia: the mobility-cognition paradigm

The purpose of the study was to evaluate patient factors associated with urinary incontinence in nursing homes to identify the relative importance of these factors in predicting urinary incontinence. Cognitive ability and patient mobility were measured for 61 patients residing in a nursing home. Twenty-nine of the patients were incontinent and 32 continent. Cognitive ability and mobility were found to differ significantly between continent and incontinent patients. When the variables were examined together, mobility emerged as the best predictor of the patient's urine control, followed by cognitive impairment. The findings highlight the importance of addressing patient mobility issues when dealing with urinary incontinence in nursing homes.     

Prompted voiding therapy for urinary incontinence in aged female nursing home residents

A study of 85 incontinent female nursing home residents explored the effects of two nursing interventions (prompted voiding and socialization) on incontinence. Findings indicate that a controlled prompted voiding programme is useful in decreasing incontinent episodes. Positive effects of prompted voiding were noted over a 5-week experimental period. It is suggested that nursing homes incorporate prompted voiding into their care. Nursing homes adopting this protocol should be encouraged to keep data that will contribute further to knowledge in this area. Recommendations for additional research are made.     

Pain assessment practices with nursing home residents

The purpose of this research was to describe the kinds of pain assessments nursing home staff use with nursing home residents and the characteristics and behaviors of residents that staff consider as they assess pain. Twenty-one focus groups were held in 12 nursing homes. Nurses and other nursing home staff attended the focus groups. Coding techniques consistent with ethnographic methodology were used for data analysis. Four themes identified an underlying uncertainty in assessing residents' pain, the staff relationship-centered approach to pain assessment, the resident cues that alert staff to pain, and residents' characteristics important to the nursing assessment. Composition of focus groups made a difference in participation of certified nursing assistants in focus group discussion. Urban and rural differences were noted across the focus groups. Research is needed to further refine pain assessment techniques specifically for nursing home settings.     

Barriers to nutrition care for nursing home residents

The prevalence of protein-calorie malnutrition (PCM) in nursing home residents has reached 85% in some nursing homes and is linked to increased mortality among residents. Separate survey questionnaires were developed and administered to 99 nursing assistants and 44 nurses (35 RNs, 9 LPNs) from five eastern Washington nursing homes. The purpose was to assess nurse (RN, LPN) and nursing assistant perceived beliefs and views related to nutritional needs of nursing home residents that have a potential impact on PCM of residents. Experienced nursing assistants did not view the nurse as an active participant during mealtime. Specific barriers such as a lack of time and training, too many residents, working short staffed, poor food quality, and a lack of nurse-nursing-assistant teamwork may contribute to residents not getting enough food to eat. An education program addressing staff relationships and nutrition training of nursing assistants could improve the ability of nursing staff to ensure residents' food intake and improve the quality of life for residents in nursing homes.     

The nursing costs of urinary incontinence in a nursing home population

The labor resources and costs of caring for incontinence in a nursing home population are explored. Data from a work measurement study have been applied to patient assessment results to estimate the total costs of labor for three states and the U.S. as a whole. Incontinence care costs an estimated $1.1 billion per year in the US; this represents 3 to 4 per cent of all Medicaid payments made to nursing homes.     

Attitudes of Egyptian nursing home residents towards staying in a nursing home: a qualitative study

Aim.  The aim of this study was to identify the attitudes of Egyptian nursing home residents towards staying in a nursing home and to differentiate between various types of these attitudes.
Background.  The number of older persons in Egypt who require nursing care is increasing. In response, nursing homes in bigger cities like Cairo were founded, although family care seems to be the prevalent norm.
Methods.  Semi-structured guideline interviews were performed with 21 residents from four different nursing homes in Cairo. Interviews were analyzed using qualitative content analysis.
Findings.  One category of resident was those who were sent to the nursing home by persons closely related to them. Another category made their own decision to move to a nursing home. Relationships with social networks and self-help abilities are factors of importance in influencing decision-making.
Conclusion.  Nursing homes in Egypt fulfil different functions for different types of older persons. Charitable institutions are a last resort for those with no income and a disrupted social network. For better-off older persons, nursing homes may provide the benefits of socialising with peers and receiving medical treatment.     

Responses of nursing home residents to intrainstitutional relocation.

Relocation effects may be positive when residents are prepared for the move. The degree to which they exercise control over their environment and participate in the decision-making process influences the outcome of relocation. Planned interventions may offset adverse effects of stress. Prerelocation involvement of the residents we observed in visiting the new facility, and in selecting their bedrooms and roommates, reduced their anxiety to an acceptable, even positive level. These choices had a direct impact on their quality of life. The greater the number of choices the residents had, the more predictable the new environment became. Any stress generated became a positive, rather than a negative, force.     

Analyses of nursing home residents with cancer at admission

The objective of the study was to profile nursing home residents with cancer at admission to the nursing facility. We used all admission assessments in the Minimum Data Set recorded throughout the United States during 2002 to identify 61,890 residents with cancer, or 11.3% of all admissions. Nursing home residents with cancer were significantly older and more likely to be male than other residents at admission. Large proportions of nursing home residents with cancer were activities of daily living dependent and about 55% used a wheelchair as their primary mode of locomotion. More than 37% of residents with cancer experienced at least moderate daily pain at admission and almost 26% had a diagnosis of depression. At admission, more than half of residents with cancer had an unstable health condition, 21% were judged to be in their final 6 months of life, and 19% received hospice care. More than 40% of residents with cancer had no advance directives recorded at admission. Compared to other residents at admission, larger proportions of residents with cancer require heavy care. Staff at nursing facilities need to address depression, pain management, and the implementation of advance directives to improve the quality of life for residents with cancer.     

The relationship of nursing staff to the hospitalization of nursing home residents

Researchers have found registered nurse (RN) staffing unrelated to the prevention of hospitalizations of nursing home residents. Although most nursing home admissions are from hospitals, their studies involved residents who probably were not admitted from hospitals. In this study I examined data on 6,623 discharges of nursing home residents admitted or not admitted from a hospital. For patients with longer stays (>30 days), higher RN staffing levels in nursing homes reduced hospitalizations only for residents admitted from hospitals. Higher RN levels reduced hospitalizations more than higher licensed nurse levels or skill mix. Only among longer-stay residents not admitted from hospitals was RN staffing unrelated to hospitalizations. Researchers may have found RN staffing unrelated to hospitalizations because samples were primarily longer-stay residents not admitted from hospitals.     

Spirituality and the elderly: nursing implications with nursing home residents

Spiritual care is integral to quality nursing care for nursing home residents. Spirituality can be defined as dynamic principles developed throughout the lifespan that guide a person's view of the world; influence his or her interpretation of a higher power, hope, morals, loss, faith, love, and trust; and provide structure and meaning to everyday activities. Spiritually focused nursing interventions include silent witnessing, serving as a liaison, and active listening. Nursing interventions for spiritual care can be divided into four dynamic phases: self-comfort, assessment, intervention, and evaluation. Spiritual well-being helps residents' total well-being and inner peace.