Decreasing Urinary Incontinence in Home Healthcare

Urinary incontinence (UI) in older adult patients poses a risk for complications and hospitalization. The aim of this quality improvement project was to develop and implement a protocol to promote continence in older adults with UI. Data were collected from a convenience sample of 26 participants, 80 years of age or older, in a midsize suburban home care agency. All participants were diagnosed with UI as documented in the Outcomes and Assessment Information Set (OASIS). OASIS question M1610 was used to identify patients with UI status, and M1650 was used, to identify UI frequency. The outcomes for these questions were assessed to examine change over time in UI status and frequency. Eligible patients completed a 3-day bladder diary, then patient education was conducted on UI, risk factors, bladder training, pelvic floor exercises, and hydration/nutrition parameters. Patients then completed 3-day bladder diaries postintervention. At pretest, 100% of the participants were incontinent. At posttest, 24 participants (92.3%) were incontinent. The results suggest that the median frequency of UI declined overtime from 2 (range: 1-4) at pretest to 1 (range: 0-4) at posttest. This decline was statistically significant (z = -3.83; p < .001). Future studies should examine changes in the UI complications and hospitalization rates.