DRIP

Detect, Reduce, Incontinence, Programme

Thierry Pepersack on behalf of the College of Geriatrics

Introduction

• urinary incontinence is a straightforward condition, its cause easily identified and treated, treatment can have a major impact on the older person's quality of life

Two phases projet

Part 1: Outcomes

Prevalence of urinary incontinence among

geriatric units

Classification of incontinence

Characterisation of the geriatric teams and of the

professionals implicated in the management of

incontinence

Part 1: Methodology

• Survey design: transversal

• Questionnaire by mail, web site

• Data collect of the characteristics of– hospitals– teams– patients

Results

Prevalence of incontinence(N=834 patients)

26% A cute

5 7 % fu n c tion a l 1 5 % u rg e 1 4 % overflow 6 % D H IC 2 % re flex

74% C hronic

45% of incontinent pa tients

Types of chronic incontinence

overflow14%

stress6%

urge15%

reflex2%

functional57%

DHIC6%

Characteristics of the hospitals

Characteristics of the teams

Characteristics of the teams50 % of the centres have professionals implicated in the management of incontinence

0%

10%

20%

30%

40%

50%

60%

70%

80%

Nurse physiotherapist Geriatrician

Characteristics of the teamsprocedures used in the management of chronic incontinence

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

history urodynamic sheet bacteriolocal

Characteristics of the teams/patientsFactors associated with the absence of incontinence management

0% 10% 20% 30% 40% 50% 60%

severe cognitiveimpairment

severe functionalimpairment

burnout of the team

lack of profesionalformation/interest

Characteristics of the patients

functional impairment

17%

diuresis control17%

decubitus ulcer(s)

24%

palliative approach

17%

retention25%

Characteristics of the patients13% under continued catheterization, why?

Characteristics of the patients13% under intermittent catheterization, why?

diuresis control50%

decubitus ulcer(s)

8%

residu42%

Relationship between % of incontinent patientsand patients’ and teams’ characteristics

Discussion (1)

• 45% of incontinent patients in geriatric units

• 26% of transient incontinence

• Functional incontinence represents more than the half of the chronic situations

• Incontinence is associated with:– High length of stay– High proportion of demented patients

Discussion (2)

• Biais of selection? (Only the performant centres have answered?)

Discussion (2)

• A interventional proposition will complete this survey based on valided guidelines

Part 2

Part 2: Objectives

• enhance quality of care among geriatric unit providing suggestions about topics which are considered important for the majority of the patients.

• improve not only the quality of life of our patients but also the quality of life of the geriatric team’s professionals.