Authors (including presenting author) :
Aboo GH(1)(2),Pun KL (1)(2), Lui KLG(3), SinTCS(2), Yang SFA(4), Chan MFM(5), Lui YCJ(1), Wong PCC(1), Leung YKK (1), Chan YKJ(1)(6), Lau CW(1)
Affiliation :
(1)Quality & Safety Office, Hong Kong East Cluster, (2)Nursing Services Division, Pamela Youde Nethersole Eastern Hospital, (3)Department of Surgery, Pamela Youde Nethersole Eastern Hospital, (4) Nursing Services Division, Tung Wah Eastern Hospital, (5)Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital,(6)Department of Medicine, Pamela Youde Nethersole Eastern Hospital
Introduction :
Adult diapers are commonly used for various reasons, and there are existing and first-time users. Unnecessary use of diapers affects the clinical course, deprives patients of dignity, and increases workload. The Cluster Working Group of Appropriate Diaper Use was formed in May 2018 to tackle this issue.
Objectives :
The present study aimed to understand the prevalence and reasons of diaper use, and collect staff opinion on the way forward.
Methodology :
This was an observational study performed in November to December 2019 in 21 acute wards of surgical, medical, orthopaedic, oncology, gynaecology of PYNEH, and 11 medical rehabilitation wards of TWEH. The following data were collected from record review, electronic Patient Assessment Form, Intake and Output (I/O) Chart, Nursing Care Plan, Nursing Prescription, sociodemographic, reason for current hospitalization, diaper use before hospitalization; and reason for diaper use during hospitalization. Data was also obtained from an anonymous staff opinion survey on diaper use during a Cluster Quality & Safety Forum on Appropriate Diaper Use in November 2019.
Result & Outcome :
Discussion Diaper use was common, and one-fifth was first-time users. Documentation was variable, and there was a lack of an early wean-off plan. Appropriate use and early wean-off of diaper should be promoted. The strategies would require multi-disciplinary effort to enhance patient’s mobility and independence, fall prevention, good diet, adequate hydration and treatment of diarrhoea, staff knowledge on continence care and incontinence products, and provision of patient transfer equipment and toilet facilities. A convenience sample of 1236 patients (1015 acute and 221 rehabilitation) was included. The overall prevalence rate of diaper use was 43.0% (n=532, 40.8% male, 60.9% ≥81 years old.). The prevalence rates in acute and rehabilitation hospitals were 37.4% in acute hospitals and 68.8% in rehabilitation hospitals. Around 20% of patients, 203 and 48 in the acute and rehabilitation hospitals respectively were first-time diaper users. The most prevalent reasons for diaper use were mobility impairment, urinary / faecal incontinence or diarrhoea, and risk of fall. Nursing documentation of diaper use varied among wards: most were recorded on I/O chart, others on nursing prescription or ward record sheet, but none in the nursing care plan. From the staff opinion survey, it was agreed and worthwhile to promote appropriate diaper use, and to devise selection criteria and a plan for early weaning in each patient.
Co-location with:
