RESEARCH PAPER Incontinence: Managed or mismanaged in hospital settings? Joan Ostaszkiewicz RN MNurs Research Fellow, Deakin—Southern Health Nursing Research Centre, Victoria, Australia Beverly O’Connell RN MSc PhD FRCNA Professor, Inaugural Chair, Deakin—Southern Health Nursing Research Centre, Victoria Australia Lynne Millar BA (Hons) Research Fellow, Deakin University, Victoria, Australia Accepted for publication August 2008 Ostaszkiewicz J, O’Connell B, Millar L. International Journal of Nursing Practice 2008; 14: 495–502 Incontinence: Managed or mismanaged in hospital settings? This paper reports the results of a survey of inpatients to determine the prevalence of their continence status and the overall management of their incontinence. A survey of 447 hospitalized adults was conducted and an audit of their medical records. Twenty-two per cent of patients reported urinary incontinence, 10% faecal incontinence, 78% nocturia, 23% urinary urgency and 11% trouble passing urine. Pre-existing bladder and bowel problems were reported by 34% and 26% of patients respectively. Sixty per cent of patients were using a continence product or device. There was a lack of documentation in the medical records about patients’ continence status and about their pre-admission bowel and bladder status. The findings reveal that the management of incontinence in acute and subacute settings is suboptimal. There is a need to raise clinical awareness about incontinence in hospital settings and to implement a structured approach to its assessment and management. Furthermore, as the costs associated with the management or mismanagement of inconti- nence in hospital settings are not fully understood, there is a need for further research on this issue. Key words: assessment, documentation, hospital, incontinence, prevalence. INTRODUCTION There is a large body of evidence on the prevalence and nature of bowel and bladder elimination symptoms among community dwelling non-institutionalized adults. 1 By contrast, there is a lack of information about these symp- toms for individuals admitted to hospital settings. Gener- alizing data from a population of community dwelling non-institutionalized adults to inpatients of hospital set- tings is problematic and should be done cautiously owing to important differences in these populations, such as health and functional status. The limited data that are available from published research on incontinence in hos- pital settings reveal that much of this research was con- ducted some time ago and only two studies provide data on the Australian population. 2,3 It also reveals that the prevalence of incontinence in hospital settings is wide ranging; from 10.5 to 43% for urinary incontinence and 7 to 33% for faecal incontinence 2–14 (see Table 1 for Correspondence: Joan Ostaszkiewicz, Deakin—Southern Health Nursing Research Centre, School of Nursing, Deakin University, 221 Burwood Hwy, Burwood, Vic. 3124, Australia. Email: joan. ostaszkiewicz@deakin.edu.au International Journal of Nursing Practice 2008; 14: 495–502 doi:10.1111/j.1440-172X.2008.00725.x © 2008 Blackwell Publishing Asia Pty Ltd