Prevalence of Incontinence and Associated Skin Injury in the Acute Care Inpatient

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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 (≤ 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.

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