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Ultrasound-assisted prompted voiding care for managing urinary incontinence in nursing homes: A randomized clinical trial.

ABSTRACT: AIMS:To determine whether ultrasound-assisted prompted voiding (USAPV) care is more efficacious than conventional prompted voiding (CPV) care for managing urinary incontinence in nursing homes. METHODS:Thirteen participating nursing homes in Japan were randomized to CPV (n?=?7) or USAPV care group (n?=?6). Residents of the allocated nursing homes received CPV (n?=?35) or USAPV (n?=?45) care for 8 weeks. In the CPV group, caregivers asked the elderly every 2-3?h whether they had a desire to void and prompted them to void when the response was yes. In the USAPV group, caregivers regularly monitored bladder urine volume by an ultrasound device and prompted them to void when the volume reached close to the individually optimized bladder capacity. Frequency-volume chart was recorded at the baseline and after the 8-week intervention to measure the daytime urine loss. RESULTS:The change in daytime urine loss was statistically greater in the USAPV (median, -80.0?g) than in the CPV (median, -9.0?g; P?=?.018) group. The proportion of elderly individuals whose daytime urine loss decreased by >25% was 51% and 26% in the USAPV and CPV group, respectively (P?=?.020). Quality-of-life measures of elderly participants showed no significant changes in both groups. The care burden scale score of caregivers was unchanged in the USAPV group (P?=?.59) but significantly worsened in the CPV group (P?=?.010) after the intervention. CONCLUSIONS:USAPV is efficacious and feasible for managing urinary incontinence in nursing homes.

SUBMITTER: Suzuki M

PROVIDER: S-EPMC6849834 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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Ultrasound-assisted prompted voiding care for managing urinary incontinence in nursing homes: A randomized clinical trial.

Suzuki Motofumi M Miyazaki Hideyo H Kamei Jun J Yoshida Mikako M Taniguchi Tamami T Nishimura Kaoru K Igawa Yasuhiko Y Sanada Hiromi H Homma Yukio Y

Neurourology and urodynamics 20190108 2

<h4>Aims</h4>To determine whether ultrasound-assisted prompted voiding (USAPV) care is more efficacious than conventional prompted voiding (CPV) care for managing urinary incontinence in nursing homes.<h4>Methods</h4>Thirteen participating nursing homes in Japan were randomized to CPV (n = 7) or USAPV care group (n = 6). Residents of the allocated nursing homes received CPV (n = 35) or USAPV (n = 45) care for 8 weeks. In the CPV group, caregivers asked the elderly every 2-3 h whether they had a ...[more]

PMID: 30620134

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Project description:Background Diagnosing urinary tract infections (UTI) in nursing home residents is complex, due to frequent non-specific symptomatology and asymptomatic bacteriuria. The objective of this study was to explore health care professionals’ perceptions of the proposed use of inflammatory marker Point-Of-Care Testing (POCT) in this respect. Methods We conducted a qualitative inquiry (2018–2019) alongside the multicenter PROGRESS study (NL6293), which assessed the sensitivity of C-reactive protein and procalcitonin POCT in UTI. We used semi-structured face-to-face interviews. The participants were physicians (n?=?12) and nurses (n?=?6) from 13 nursing homes in the Netherlands. Most respondents were not familiar with inflammatory marker POCT, while some used POCT for respiratory tract infections. Both the interview guide and the analysis of the interview transcripts were based on the Consolidated Framework for Implementation Research. Results All respondents acknowledged that sufficiently sensitive POCT could decrease diagnostic uncertainty to some extent in residents presenting with non-specific symptoms. They primarily thought that negative test results would rule out UTI and justify withholding antibiotic treatment. Secondly, they described how positive test results could rule in UTI and justify antimicrobial treatment. However, most respondents also expected new diagnostic uncertainties to arise. Firstly, in case of negative test results, they were not sure how to deal with residents’ persisting non-specific symptoms. Secondly, in case of positive test results, they feared overlooking infections other than UTI. These new uncertainties could lead to inappropriate antibiotics use. Therefore, POCT was thought to create a false sense of confidence. Conclusions Our study suggests that inflammatory marker POCT will only improve UTI management in nursing homes to some extent. To realize the expected added value, any implementation of POCT requires thorough guidance to ensure appropriate use. Developing UTI markers with high negative and positive predictive values may offer greater potential to improve UTI management in nursing homes. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-020-01853-9.

Dataset Information

Ultrasound-assisted prompted voiding care for managing urinary incontinence in nursing homes: A randomized clinical trial.

Publications

Ultrasound-assisted prompted voiding care for managing urinary incontinence in nursing homes: A randomized clinical trial.

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