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[Evaluation of the system of direct purchase and distribution of urinary incontinence pads in primary care centers].

OBJECTIVE: To evaluate the impact of the pilot experience of direct purchase and distribution of incontinence diapers in primary health care centres of the Balearic Islands after 10 months of implementation. DESIGN: Comparison of diapers's public expenditures and use during 10 months of pilot experience (9/1/1994-6/30/1995: POSTC) to a same length period prior to pilot experience implementation (11/1/1993-8/31/1994: PREC). SETTING: Primary health care centres of the Balearic Islands (Spain). MEASUREMENTS AND RESULTS: Monthly mean of packages used in the PREC period was 3,246 packages/month, whereas monthly mean of packages used in POSTC period was 4,541 packages/month. It means an increase of 1,295 packages/month. The mean price per package got by public tender was 4,426 ptas., nearly half of mean unit price per package paid through the usual dispensing system of medical prescription (8,583 ptas.), thus producing a saving of 4,157 ptas. per package. A decreasing trend to the monthly mean of diapers use of the PREC period was observed in the last months of the experience. The monthly expenditures in diapers was 27,790 milions ptas. in the PREC period and 21,024 milions ptas. during the POSTC period. CONCLUSIONS: The expected increase in diapers use during the first year of implementation of this measure was 34.86%. Of this increase, 70.5% is attributed to development of stock in centres and the undergoing trend of diapers demand increase observed throughout the country.

Costs and Cost Analysis↗

Bacteriuria detection with a urine dipstick applied to incontinence pads of nursing home residents.

The purpose of this study was to evaluate a new method of initial on-site evaluation of bacteriuria in an incontinent nursing home population. Nitrite and a composite of nitrite and/or leukocyte esterase results of the new method were compared with clean-catch urine culture results of each participant to determine sensitivity, specificity, positive and negative predictive values, and efficiency. These findings were compared with results of the traditional dipstick urinalysis for bacteriuria assessment. The new method was as effective as the traditional method in assessing both the presence and absence of bacteriuria. Results of this study indicate the new dipstick/pad method may assist in the assessment of bacteriuria in incontinent nursing home residents.

Aged↗

Pyuria detection using a dipstick applied to urine in incontinence pads.

The purpose of this study was to determine whether pressing a dipstick into a pad within 2 hours of urine saturation detected pyuria as effectively as immersing a dipstick in a urine specimen. Sensitivity, specificity, and positive and negative predictive values indicated that results of the pad method were as effective as those of direct dipstick into clean-catch urine in detecting pyuria. In the elderly, sensitivity of the pad method was 100%, indicating this would be an effective method for initial assessment of pyuria.

Adolescent↗

Effects of absorbent incontinence pads on pressure management mattresses.

AIM: The aim of this paper is to report a study to determine the effects of absorbent pads on the pressure-relieving properties of 'standard' and pressure management mattresses. BACKGROUND: Pressure ulcers and incontinence often co-exist. There is a strong association between poor mobility and continence problems and patients using pressure management products are therefore also likely to be using absorbent pads. METHODS: An instrumented articulated anthropometric phantom with simulated soft body 'tissues' in the gluteal and sacral areas was used as the 'subject'. The phantom was raised and lowered on to three mattresses (standard foam, visco-elastic foam and surface-cut foam) in three states: naked, wearing a dry pad (Tena Super, SCA Hygiene AB) and wearing a wet pad. The pressure mapping device Xsensor was used to record the distribution of pressure over the sacral and ischial areas of the phantom. Peak pressure was used as the primary outcome variable and 10 repeats were made on each mattress under each condition. RESULTS: There were substantial and significant differences for all three mattresses in recorded peak pressures between the naked buttocks and the buttocks wearing a dry pad. There were no significant differences between measurements made using the dry vs. wet pad. Peak pressures frequently occurred over areas of pad folds. Additional testing showed that pads that were 'smoothed' by hand had significantly lower peak pressures than 'unsmoothed' pads. CONCLUSIONS: Absorbent pads have a substantial adverse effect on the pressure redistribution properties of mattresses. Pad folds appear to contribute to this effect, which can be ameliorated slightly by smoothing. Absorbent pad manufacturers should consider engineering pads that minimize disruption to pressure management. Further examination of continence and pressure management products is necessary to establish optimum combinations for nursing care.

Aged↗

TENA flex: a new concept in disposable incontinence pads.

The development of adult or larger-sized all-in-one incontinence products continues to improve. The latest addition to the many products available for the management of moderate to heavy urinary incontinence is TENA flex, manufactured by SCA Hygiene Products. TENA flex is an all-in-one belt-style product, which does not require separate fixation as with a pad and pant system, and relies upon a different measurement process to ensure proper pad selection, fitting and positioning. The range of TENA flex features will be discussed in this article.

Adult↗

Selecting the correct incontinence pad in nursing home patients by pad weighing.

The aim of this study was to identify which types of absorbent pads were being used by the inhabitants of two nursing home wards and to determine to what extent the pads were adapted to the patient's leakage volume. An objective assessment of urinary leakage was performed in all the men (age 80.2 +/- 8.0 years) and women (age 84.8 +/- 6.5 years), from the two wards, who used incontinent aids (n=41). Subjects were assessed by weighing all incontinence aids on a precision weight scale before and after use during a period of 7 days. The number of patients experiencing wetting of external clothing or bedding was recorded. During the assessment period 1146 pads were used and the mean urinary leakage per patient during the day was 260 +/- 212 ml and during the night 413 +/- 230 ml. Wetting of external clothing or bedding occurred during the day time in 16% and in 40% at night time despite the use of pads. Only 22% of the pads were adapted to the patients degree of urinary incontinence. Many of the nursing home inhabitants were using larger pads than necessary. If the pads had been adapted to the patient's urinary leakage volume, costs for incontinence aids would have been reduced by 31%.

Journal Article↗

Incontinence pads.

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Bedding and Linens↗