Prevalence of incontinence and associated skin injury in the acute care inpatient

Abstract

Purpose: We examined the prevalence of incontinence and skin injury in areas exposed to incontinence among inpatients at 2 hospitals.

Subjects and setting: Acute care patients in medical, surgical, and intensive care units at a community and teaching hospital were surveyed to determine the rates of urinary and fecal incontinence and the prevalence of incontinence-associated dermatitis or skin ulceration.

Instrument: A data collection form that queried patient characteristics was completed. The presence of hypoalbuminemia (< or = 3.4 g/dL) and nutrition, friction and shear, and mobility status (using Braden scale scores) were also recorded. This instrument was designed by this research team and tested in a pilot study.

Results: A total of 608 patients age 4 years and older were surveyed. The overall prevalence of incontinence in the survey was 19.7% (120 of 608). One hundred seven patients (17.6%) were incontinent of stool. Fecal incontinence was more frequent than urinary incontinence overall, by gender and across the different age groups. However, 201 (33%) of the inpatients had indwelling urinary catheters and were counted as continent of urine. The highest prevalence of incontinence was found in the oldest age group (80+ years). Some type of injury to the skin was observed in 42.5% of the 120 patients who were incontinent. Hypoalbuminemia and poor nutritional status were more commonly noted in patients with skin injury associated with fecal incontinence.

Conclusion: Fecal and urinary incontinence are common among patients in the acute care setting. Fecal incontinence is associated with hypoalbuminemia and poor nutritional status and is associated with a higher rate of skin injury.