Purpose/Objective: The purpose of this project was to evaluate urinary incontinence prevention, resident evaluation, and incontinence product use in my three long term care facilities.

Methodology: The evaluation and implementation was divided up into three tasks, prevention, incontinence evaluation, and product use. Evaluation was accomplished by visual rounds and staff interview.

Prevention was disjointed and inconsistent. Incontinence skin care products were made available in all homes; a basic cleanser and barrier were implemented as per the prevention piece of the regulation. Nursing staff was inserviced in IAD and how to record it separately from other skin problems so the statistics in it could be tracked as erosion of skin is a level 3 citation. The rates were reported and a protocol for treatment of IAD was implemented. In all buildings the rehab nurse did the incontinence diaries and recommendations. The only changes there were in the admission assessment to reflect transient causes of UI and for a formal evaluation sheet to record that resident’s schedule and individualized incontinence products. Incontinence products were implemented as final phase, adding incontinence pads, liners, and pull ups in addition to the briefs to address dignity issues. Types of product are based upon the resident’s level of incontinence and if it is double incontinence as well as resident preference.

Outcome: No deficiencies on the tags in any building; IAD is tracked and rates reported, as high as 10% initially but baseline as 0-3% after changes implemented. Rehab continues to do toileting schedules and varieties of products allow resident choices and dignity in the management of their intractable incontinence. Transient causes are formally addressed on admission and with change in condition of the incontinence status.