Susi Saxer

Patient experience with bedpans in acute care: a cross-sectional study.

AIMS AND OBJECTIVES To describe individual experiences of patients using the bedpan in an acute care setting. BACKGROUND Patients describe the use of the bedpan often as uncomfortable and painful, and nurses mention difficulties using standard-sized bedpans for obese patients or removing a bedpan without soiling the bed. Although the bedpan is still regularly used in hospitals, there are few empirical studies that confirm these experiences. DESIGN A descriptive quantitative research design. METHODS A convenience sample of 78 patients was recruited, and data were collected using a standardised questionnaire (German version of the Bedpan Ongemak Schaal). Descriptive statistics were used to analyse frequency (scale A) and extent of inconvenient experiences (scale B). Internal consistency of the scales was tested using Cronbachs alpha. RESULTS A major finding of the study was that most patients felt dependent on other persons and no autonomous movement was possible on the bedpan. Patients were frequently confronted with pain, inconvenient characteristics of the bedpan (e.g. coldness, hardness), uncomfortable positions and hygiene inconveniences (e.g. wet backside, fear that urination may miss the bedpan). CONCLUSION As the bedpan is still regularly used in acute care hospitals, innovations in bedpan models are necessary to address the problems. But there are also several courses of action nurses should consider when caring for patients who are dependent on the bedpan. RELEVANCE FOR CLINICAL PRACTICE The discomfort of the bedpan, the feeling of dependency and embarrassment could lead to undesirable patient reactions, such as avoidance of fluid intake or leaving the bed. If nurses know the reasons for this behaviour, they could meet these problems with empathetic understanding.

Experiences and needs of relatives of people with dementia in acute hospitals—A meta‐synthesis of qualitative studies

AIMS AND OBJECTIVES To present an in-depth analysis of existing qualitative literature concerning experiences and needs of the relatives of patients with dementia in hospitals. BACKGROUND Relatives are an important resource for the care of patients with dementia in hospitals. They provide necessary information about the patient and can support the patients care. Simultaneously, they are themselves vulnerable, having specific needs and experiences. A number of studies have been conducted that focus on the perspectives of the relatives. The synthesis of qualitative studies contributes to a more comprehensive understanding of recent study findings. DESIGN A meta-ethnographic synthesis of qualitative research findings was used. METHODS The synthesis process followed six defined steps. We located relevant studies through searching the CINAHL, PubMed and PsycInfo databases and through searching journals and reference lists by hand. A list of metaphors was created and translated into one another. Identified metaphors were synthesised and interpreted as a new whole. RESULTS Relatives of patients with dementia frequently experience a negative cycle of specific worries, negative feelings and resulting roles and functions in hospital due to negative care experiences. CONCLUSIONS Experiences of relatives are strongly influenced by the attitudes, expertise and communication that they receive from health professionals working in the hospital. The results clearly show how health professionals have the potential to break through the negative cycle and contribute to a more positive feeling about a patients hospital stay. RELEVANCE TO CLINICAL PRACTICE Structured and individually planned involvement of the relatives during the hospital care seems to be a key aspect for improving the experiences for the relatives and the patients with dementia. Collaboration with the relatives needs to be valued and supported by the organisation. Also a professional and defined frame for this area of responsibility needs to be provided.

Continence profiles. A way to enhance assessment of urinary continence in German nursing practice.

The German expert standard “Promotion of urinary continence in nursing” was developed and implemented to support nursing practice. The group of experts involved identified the assessment of (in)continence situations and the evaluation of outcomes as a central problem for successful continence care. They, therefore, developed an assessment instrument in the German language, namely six continence profiles, to help differentiate between continence and incontinence. It also takes into account the extent to which the relevant situation can be promoted or compensated by the application of measures, on the one hand, and independently or dependent on nursing staff assistance, on the other hand. The profiles were developed based on theories and implemented into practice as a model. The current paper describes the theoretical background and development process as well as early results from implementation and testing. However, a comprehensive scientific study must still be performed.ZusammenfassungZur Unterstützung der pflegerischen Praxis wurde der Deutsche Expertenstandard „Förderung der Harnkontinenz in der Pflege“ entwickelt und implementiert. Die beteiligte Expertengruppe identifizierte das Assessment der (In-)Kontinenzsituation und die Evaluation von Ergebnissen als ein zentrales Problem einer erfolgreichen Kontinenzpflege. Sie entwickelte daher ein deutschsprachiges Einschätzungsinstrument, die sechs Kontinenzprofile. Damit kann einerseits eine Unterscheidung in Kontinenz oder Inkontinenz vorgenommen werden. Andererseits wird berücksichtigt, inwieweit die jeweilige Situation durch den Einsatz von Maßnahmen oder Hilfsmitteln sowie selbstständig oder abhängig von der Unterstützung durch Pflegekräfte gefördert oder kompensiert wird. Die Profile wurden theoriegeleitet entwickelt und in der Praxis modellhaft implementiert. Beschrieben werden Hintergrund, Entwicklungsprozess und erste Ergebnisse aus Implementierung. Eine umfassende wissenschaftliche Überprüfung steht noch aus.

Urininkontinenz bei neurologischen Krankheiten

ZusammenfassungIn einer Schweizer Rehabilitationsklinik wurde die Prävalenz von Urininkontinenz bei Patientinnen und Patienten mit Hirnschlag, Multiple Sklerose und primäres Parkinson-Syndrom identifiziert. Die Ergebnisse zeigten bei der Gesamtstichprobe eine Prävalenz von 38,6% bei Eintritt und 30% bei Austritt. Unterschiede zeigten sich zwischen den einzelnen Diagnosen. Der Grad der Selbstständigkeit und die Kognition beeinflussten die Urininkontinenz signifikant sowohl bei der Gesamtstichprobe, als auch bei den einzelnen Diagnosen. Eine Sensibilisierung des Behandlungsteams und Beratungsangebote sind aus diesem Grund wichtig. Weitere Untersuchungen zur Prävalenz, den Auswirkungen der Urininkontinenz und zur Wirksamkeit von Interventionen sind notwendig.

Post-Cerebrovascular Accident Unpredictable Incontinence: A Qualitative Analysis of an Interdisciplinary Rehabilitation Team’s Perspective

Purpose This study investigates experiences of the interdisciplinary rehabilitation team in the treatment of patients with urinary incontinence after stroke. Design A qualitative approach was chosen. Ten members of an interdisciplinary treatment team were interviewed in a neurological inpatient rehabilitation setting. Methods Data were obtained via focus groups with nurses, physicians, physiotherapists, and occupational therapists in a rehabilitation clinic. The analysis followed the principles of qualitative content analysis. Findings According to the interdisciplinary treatment team, professionals and patients prioritize incontinence treatment differently. Challenges surrounding collaboration, communication, structural conditions, and the perception of intervention success were identified as barriers to promoting continence. Conclusion To overcome this discrepancy in treatment priority, awareness of poststroke urinary incontinence must be improved. Clinical Relevance A key component is communication about urinary incontinence with patients and among team members.