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.     

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.     

护士对静脉治疗护理技术操作规范掌握情况的调查

目的了解临床护士对静脉治疗护理技术操作规范的相关知识掌握现状,分析存在问题,为静脉治疗护理培训提供依据。方法便利选取某三级甲等医院183名临床护士,采用贵州省护理学会编制的静脉治疗护理技术操作规范卫生行业标准实践现状调查问卷进行调查。结果83.7%(153/183)的调查对象通过院内静脉治疗小组培训获取静脉治疗技术操作规范相关知识。74.3%(136/183)的调查对象接受过相关操作规范培训。护士对静脉治疗技术操作规范知识掌握情况欠佳,其中对输液接头及附加装置更换要求(5.5%)、PVC穿刺的注意事项(4.9%)这2个条目掌握率最低。结论护士对静脉治疗护理技术操作规范的知晓率及掌握情况均欠佳,护理管理者需有针对性地制订培训方案,提高护士对静脉治疗知识及相关技能的知晓及掌握程度,注重效果反馈和质量监督,重视静脉治疗护理专科队伍的建设。     

Nurses' knowledge and beliefs about continence interventions in long-term care

Incontinence in nursing homes is a prevalent condition requiring a programmatic approach due to its diverse aetiology Awareness of antecedent factors, such as knowledge and beliefs about incontinence and its treatment by the individuals responsible for establishing and maintaining a continence programme, is important prior to implementation A questionnaire was administered to licensed nurses who attended a workshop on urinary incontinence in nursing homes One purpose of the questionnaire was to elicit information about beliefs regarding the effects of continence programmes on residents and staff and potential staff reaction to implementation of a continence programme in then- facility Responses by licensed practical nurses (LPNs) were compared to the responses of registered nurses (RNs) Attribution for causes of incontinence differed between LPNs and RNs There were no significant differences in the report of current routine nursing care which included scheduled toileting, changing clothing when necessary, and use of adult briefs and underpads Most nurses anticipated a favourable reaction by the staff to the implementation of a continence programme However, at least 20% responded that the nursing staff would be apathetic or resistant to a programme Administrative support was infrequently chosen as the most important factor in the implementation of a programme. The implications of these findings to continence programmes that are integrated into the organization and provide comprehensive services, including preventive interventions, are discussed     

Managing urinary incontinence in the nursing home: residents' perspectives

The purpose of this study was to develop a substantive theory describing and explaining cognitive, psychosocial, and behavioural aspects of living with urinary incontinence in a nursing home. Using grounded theory methodology, data were obtained from interviews, participant observation, and minutes from meetings of resident advisory councils, and analysed concurrently using the constant comparative method. Three nursing homes located in the metropolitan area of a major American city served as sites for the study. Ethical approval was obtained from the administrator of each facility and institutional review board of a major university. Ten residents served as primary participants, consenting to provide one audiotaped formal interview, subsequent opportunities to observe and discuss their methods of bladder control, and access to their health care records. Another 33 residents from these facilities served as secondary participants, providing opportunities for observation and informal interview when their bladder control needs, issues, or methods were visible to the investigator and seemed relevant to the evolving theory. Data were collected over a period of 17 months. Findings suggest that nursing home residents with actual or potential urinary incontinence engage in a process called managing urinary incontinence. Managing urinary incontinence occurs in the context of believing that it is an inevitable part of ageing and seeking to protect physical, psychological, and social integrity. Managing urinary incontinence is a dynamic process with consequences that are influenced by the degree to which six specific strategies are used with satisfaction by the resident and supported by staff and significant others. Implications for nursing practice and research are discussed.     

Nurses' knowledge and attitudes about antibiotic therapy in critical care.

PURPOSE: To assess critical care nurses' knowledge about antibiotic use in critical care settings, and attitudes concerning the role of the nurse in monitoring response to and appropriate use of antibiotic therapy. METHOD: 90 critical care nurses from 6 adult critical care units at a 780-bed academic, health sciences centre, completed an investigator-developed survey about their knowledge of antibiotic use and their attitudes concerning the role of the nurse. RESULTS: The majority of respondents worked full time (83%) and were BSN (Bachelor of Science in Nursing) prepared (62%), with an average of 9 years' nursing experience and 7 years' experience in intensive care. Using a 100-mm visual analog scale, mean scores on knowledge and comfort with: (1) interpreting culture and sensitivity; (2) white blood cell (WBC) data; and (3) discussing results and therapy with physicians were all less than 50 mm. However, the mean score for nurses' belief of responsibility related to this collaborative role was 76. A knowledge quiz of lab interpretation and antibiotic therapy revealed a mean score of 53.8%. Beliefs about roles were correlated with comfort in discussing therapies with physicians rather than with knowledge. Although nurses value the collaborative surveillance role, they may lack the knowledge and confidence to enact it.     

Nurses' knowledge and attitudes on comfort nursing care for hospitalized patients

To investigate the knowledge and attitudes of practicing nurses on comfort care for hospitalized patients, a survey was conducted in 311 registered nurses from a major teaching hospital. A total of 212 (68.1%) of the participants showed an adequate knowledge of comfort care. Participants who had 6 years or more working experience returned a higher mean scores on physiological and psychological aspects of comfort care (P < 0.05). The total scores were the highest among participants from intensive care unit and the lowest among participants from the oncology department. Although 282 (90.7%) participants were involved in comfort care, only 210 (67.5%) received formal hospital‐based training in this practice. We conclude that there was a large difference in the knowledge between nurses from different departments on comfort care. Continuing education programmes are required to improve the knowledge and skills in comfort care.     

Nurses' knowledge and opinions about the nursing research process in The Netherlands

Nursing research is just gaining ground in The Netherlands, as it is in every European country Therefore, this study had the purpose of discovering to what extent Dutch nurses in the clinical areas have acquired research-based knowledge since it was introduced into the country, in the 1970s Questionnaires, which included provision for demographic data, were distributed to 110 nurses, comprising head nurses, recently qualified nurses and final-year student nurses A 65% response was achieved and the findings revealed that nursing research as a concept was not new to the Dutch nurses They claimed they had obtained their knowledge through nursing training, reading, conferences and other sources such as mass media The head nurses were the most knowledgeable followed by the recently qualified nurses and then the student nurses However, the respondents claimed that their knowledge was superficial The need to extend nurses' knowledge through support and encouragement in relation to nursing research seminars and conferences is recommended     

Prevalence of urinary incontinence among community-dwelling adults receiving home care

We conducted a cross-sectional survey in 2005 to determine the prevalence of and factors associated with urinary incontinence (UI) in adults receiving home care. Of the 2,866 patients surveyed, 46% suffered from UI; 6.5% had stress, 16.6% had urge, 9% had mixed, and 17.6% had functional incontinence. No diagnosis regarding type of UI had been established in 50.2%. Factors associated with UI were advanced age, higher body mass index, and impaired mobility. UI is prevalent in older persons receiving home care, but the lack of diagnosis of type of UI in half of the participants surveyed impedes management of UI.     

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.     

Risk factors for urinary incontinence one year after nursing home admission

Secondary data analysis was conducted from a longitudinal nursing home study to identify nonurologic risk factors for continence outcomes at 1 year after admission. Of 434 nursing home admissions, 196 subjects (45%) remained. At 1 year prevalence of incontinence was 43.8%. Age was not associated with prevalence or incidence. Risk factors identified were male gender, urinary incontinence and poor behavioral adjustment at 2 weeks, presence of dementia and impaired mobility at 2 months. Once established, incontinence tended to persist. The data suggest types of residents who might be targeted for early preventive intervention.     

对护士尿失禁知识知晓程度的调查分析

[目的]调查了解护士对尿失禁相关知识的掌握程度、态度及护理实践情况。[方法]参考Laurence的“尿失禁知识问答”自行设计了尿失禁知识、态度及相关护理实践调查问卷,对158名护士进行调查。[结果]护士尿失禁知识得分为9.40分±1.62分,尿失禁态度得分为12.33分±2.14分,尿失禁护理实践得分5.91分±1.53分。[结论]护士对尿失禁知识的了解不够深入,对尿失禁在态度和护理实践方面有不同程度的消极性。应提高护士尿失禁相关知识的掌握程度,更新观念,并鼓励护士主动参与对尿失禁病人的护理实践。     

对护士尿失禁知识知晓程度的调查分析

[目的]调查了解护士对尿失禁相关知识的掌握程度、态度及护理实践情况。[方法]参考Laurence的“尿失禁知识问答”自行设计了尿失禁知识、态度及相关护理实践调查问卷，对158名护士进行调查。[结果]护士尿失禁知识得分为9．40分±1．62分，尿失禁态度得分为12．33分±2．14分，尿失禁护理实践得分5．91分±1．53分。[结论]护士对尿失禁知识的了解不够深入，对尿失禁在态度和护理实践方面有不同程度的消极性。应提高护士尿失禁相关知识的掌握程度，更新观念，并鼓励护士主动参与对尿失禁病人的护理实践。