Abstract: Cost of Urinary Incontinence in Two Skilled Nursing Facilities: A Prospective Study

I. Barton Frenchman. "Cost of Urinary Incontinence in Two Skilled Nursing Facilities: A Prospective Study." Clinical Geriatrics 9 (January 2001) 1.

Objectives:
* To determine the cost of the multiple adult diaper changes performed each day for incontinent residents, in terms of staff time and materials employed.

Methods:
* The study was conducted at two large nursing homes in New Jersey. Calculations were made of the time and materials used to change thirty incontinent residents (fifteen at each facility). Residents participating in the study included 12 men (average age 68.4 years) and 18 women (average age 82.7 years).
* A total of seven episodes of incontinence care per resident were conducted during each 24-hour period. Fifteen certified nursing aides in each of the two facilities were timed on different shifts and at different times during the shifts. Aides followed their normal procedure for changing residents, and did not vary the protocol during the study.
* An observer recorded the time between the aide entering the resident's room and closing the door or the drapes to the time the door or drapes were opened and the aide emerged. The aides showed the observed the equipment they planned to use both before and after the timing.
* Calculated costs were based on unite costs of materials and on existing data from an unpublished internal laundering study done at one of the facility. Resource units per patient per day were calculated by multiplying the number of units per incontinence care episode by the number of episodes per day; resource costs per patient were then calculated by multiplying the unit price by the number of units per patient per day.

Results:
* The average time for each incontinence care episode was 3 minutes and 33 seconds.
* The total cost of resources used to change incontinent residents, including labor, latex gloves, diapers, and laundry, totaled $17.2089 per resident per day. The costs of non-disposable wash cloths, towels, underpads, sheets, blankets, cleanser, and lotion could not be segregated are were not included in this figure; these costs could be expected to increase the total daily cost.

Conclusions:
* "Incontinence costs in a skilled nursing facility add significantly to the overall costs of caring for residents. Results of the present study are similar to those of other studies, and underline the need to address the economic as well as related social and psychological issues [associated with caring for incontinent residents]."
* In order to "increase efficiency, reduce costs, and improve patient outcomes and quality of life," extended care facilities should continue to research the economic, social, and psychological costs of incontinence and determine methods of improving care for incontinent residents.

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