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Biomedical subjects

Diane K Newman

Publications and source records attributed to Diane K Newman.

17 recordsLinked to original sources
PubMed2006

Bladder control educational needs of older adults.

Bladder control problems, especially urinary incontinence (UI) and urinary freqency and urgency, are prevalent among older adults. The purpose of this project was to determine older adults' educational needs, preferred format, and interest in bladder control educational materials. Eighty-one older adults participated in focus groups conducted at senior centers, churches, and senior apartment dwellings located in Philadelphia, PA. A doctorally prepared nurse acted as the moderator, using a questionnaire that included items on general health issues and specific questions about bladder control issues. Participants showed interest in learning more about bladder control issues, discussed their preferences in relation to format for receiving health-related information, and expressed their interest in bladder control educational materials. This information can be used to devise an educational program about bladder control that is acceptable to older adults and can be easily accessed in settings where they reside or recreate.

Adaptation, Psychological↗
PubMed2006

Urinary incontinence, catheters, and urinary tract infections: an overview of CMS tag F 315.

The majority of nursing home residents experience some type of urinary incontinence. Other bladder-related disorders (eg, urinary retention and urinary tract infection) also are common in long-term care facilities. Efforts to manage urological conditions such as the use of indwelling catheters and absorbent products, perineal hygiene and care, toileting, and bladder rehabilitation are areas of concern and have become the subject of revised regulations. The intent of recent changes to the Centers for Medicare and Medicaid Services surveyor guidance for incontinence and urinary catheters is to ensure that: 1) incontinent residents are identified, assessed, and provided appropriate treatment, 2) indwelling catheters are not used without medical justification and removed as soon as clinically warranted, and 3) residents receive appropriate care to prevent urinary tract infections. Nursing homes must implement policies, procedures, and programs to help restore bladder function and continence in order to improve quality-of-life for nursing home residents.

Accreditation↗
PubMed2005

Innovation in bladder assessment: use of technology in extended care.

Nursing homes are required to conduct a comprehensive assessment and screening of residents with urinary incontinence (UI) and indwelling catheter upon admission, and if there is a change in cognition, physical ability, or urinary tract function (Centers for Medicare and Medicaid Services [CMS], 2005). The desired goal is to improve the quality of care through the maintenance and the restoration of bladder function. CMS regulations and revised Tag F315 mandate that long-term care facilities appropriately assess and treat the specific bladder disorder of UI and decrease the inappropriate use of indwelling urinary catheters. Assessment includes evaluation for reversible factors that may cause UI, such as urinary retention and urinary tract infection. The scope of this article is to demonstrate the relationship between these bladder disorders and assessments that can be performed by nursing staff. Because invasive instrumentation of the bladder can increase the likelihood of urinary tract infections, the use of non-invasive technology that ensures quality and evidence-based clinical practice, while preventing associated medical problems in vulnerable residents, is necessary for bladder assessment in the extended care setting. With this technology, assessment of bladder function is easy for staff and provides information that can be vital to successful nursing care outcomes. The staff of CRISTA Senior Community changed clinical practice through incorporation of technology to determine the presence of bladder dysfunction. Staff accurately and effectively applied ultrasonography to determine the bladder volume and abnormalities with bladder emptying, with ultimate improvement in resident care. Adoption of technology can preserve the resident's dignity and respect, while ensuring the highest level of bladder function.

Aged↗
PubMed2005

Assessment of diaper-clogging potential of petrolatum moisture barriers.

Petrolatum-based ointments often are used to treat and prevent incontinence dermatitis. However, anecdotal reports indicate that petrolatum ointments may affect the absorbency of disposable briefs also commonly used in incontinence management. To examine whether petrolatum ointments clog a commonly used absorbent brief, a randomized, balanced-block design study was conducted in a controlled laboratory setting to compare the brief-clogging potential of three petrolatum ointments to a non-alcohol barrier film. Test products were applied to 6-cm x 6-cm test sites on the volar forearms of 16 volunteers. Pre-weighed mini briefs were applied to the test sites in a manner that simulates normal brief wear. After 5 minutes of wear, the mini briefs were weighed to determine percent of product transfer from skin to mini brief. The mini briefs then were reapplied to the same test sites and a synthetic urine solution was introduced between the skin and the mini brief. Mini briefs subsequently were removed to determine fluid uptake by weight. Results indicate significant differences between the four test products (P < 0.01) both in percent transfer and in mini brief fluid absorption. From 59% to 69% of the petrolatum-based products transferred from the skin to the mini briefs and a 54% to 90% reduction in fluid uptake was noted, as determined by weight. The non-alcohol barrier film did not transfer to the mini brief and fluid uptake was minimally affected. Further study in the clinical and practice settings to determine the effect and consequences of barrier product transfer on absorbent garments is warranted.

Absorption↗
PubMed2004

Incontinence products and devices for the elderly.

Devices and products to contain or collect the urine are part of the management of bladder dysfunction, particularly urinary incontinence (UI) (Newman, Bliss, & Fader, in press). The aim of continence nurse experts and those who care for incontinent individuals during the past decade has been to greatly decrease the indiscriminate use of absorbent pads and garments, external collecting devices, and indwelling catheterization, through the successful treatment of urinary incontinence (UI) with behavioral interventions, drug therapies, and new surgical procedures. However, these products and devices can be beneficial for persons who are elderly, fail treatment and remain incontinent, who are too ill or disabled to participate in behavioral programs, who cannot be helped by medications, or who have a type of UI that cannot be alleviated by other interventions (Newman, 2003). The judicious use of products to contain urine loss and maintain skin integrity is a first-line defense for these patients (Fantl et al., 1996). Urinary collection devices and products that are appropriate for elderly patients, that are used by nurses in all clinical settings, and are available at local pharmacies, retail stores, medical equipment dealers or directly from manufacturers are discussed.

Aged↗
PubMed2004

Stating the case for overactive bladder: a nurse practicioner's perspective.

Overactive bladder (OAB) is a widespread syndrome characterized by symptoms of urgency, with or without urge urinary incontinence, frequency of micturition, and nocturia. Urgency is a sudden, intense, difficult-to-defer desire to pass urine and must be differentiated from normal urge or desire to void that can be deferred. It is the core symptom of OAB in the International Continence Society definition. Many misconceptions surround OAB, including that it is a normal part of aging; these contribute to the barriers to OAB diagnosis. Women are more likely than men to have OAB with incontinence; these women report diminished quality of life and are more susceptible to sleep disorders, fractures, and infections. The nurse practitioner plays an important role in diagnosing OAB during examination by eliciting specific information about symptoms from patients in their care, and in determining which treatment approaches (i.e., behavioral, pharmacologic, or a combination of both) will help them achieve optimal outcomes.

Age Distribution↗
PubMed2004

Report of a mail survey of women with bladder control disorders.

INTRODUCTION: Very little is known about a patients perception of the severity of incontinence, absorbent product use, and interaction with health care professionals despite the growing prevalence of bladder control disorders such as urinary incontinence (UI) and overactive bladder. PURPOSE: Using a simple mail-in questionnaire, this survey was meant to evaluate the limitations in intervention for UI in women due to communication shorffalls. It cites common resources utilized once a woman finds significance to her bladder control problem. The survey explores the adequacy of intervention relative to the effective availability of information, materials, and treatment. The objective was to understand the current patient-professional relationship in order to evaluate different vehicles that might effectively increase communication regarding incontinence issues. METHODS: In partnership with a mail order medical product company, the author formulated a questionnaire that was mailed by the company to 1,500 women. Half of the sample was derived from randomly selected "leads" from advertising sources and personal referrals who had identified themselves as incontinent but had never purchased incontinence supplies from them. The other half were randomly selected customers who had purchased the company's incontinence products. The 33-item multiple-choice questionnaire had 422 responses; of these, 405 women, aged 56 and older were evaluated. A research firm that conducts and analyzes consumer surveys using standard consumer research protocol tabulated results. FINDINGS: Of those suffering from UI, two groups emerged. The first felt that incontinence was related to aging, and were not embarrassed to discuss it with their physician. They had mixed feelings regarding impact on quality of life. The second group was reluctant to seek professional advice and was uncomfortable speaking about it. They felt strongly about its negative impact on daily life. Respondents from both groups who seek professional assistance still desired more information about the causes, treatments, and coping mechanisms. Most wanted more provider interaction and wanted their doctor or health care provider to proactively initiate discussion on incontinence and provide information, educational materials, and product samples. CONCLUSION: Respondents indicated that they want more information regarding incontinence. While they may not be equipped to fully understand the problem, they expect doctors, nurses, medical professionals, retail outlets, medical supply companies, and mail order houses to provide the information. Since respondents are receiving information through consumer advertising, which is usually commercially funded, a partnership between the health care community and these sources to produce this information would be ideal.

Activities of Daily Living↗
PubMedDate not supplied

Shaping future directions for incontinence research in aging adults: executive summary.

BACKGROUND: The Center for Gerontological Nursing, School of Nursing, University of Minnesota, as part of the John A. Hartford Foundation's Geriatric Nursing Initiative, convened an invitational nursing research summit on incontinence in St. Paul, Minnesota on October 16-18, 2003. OBJECTIVE: To identify new approaches for conducting urinary and fecal incontinence research in aging adults, identify strategies for reinvigorating and better positioning nursing research on incontinence, and develop recommendations for attracting new nurse investigators to incontinence research and facilitating their research training and mentorship. METHOD: Forty-seven researchers, project officers, clinician leaders, doctoral students, and consumer advocates from the United States, Canada, United Kingdom, Japan, Norway, and Australia attended a 1(1/2) day conference involving trigger talks, reaction papers, and small and large group discussions around broad thematic areas on incontinence research. Recommendations with suggested strategies were derived from the discussion groups. RESULTS: Participants identified issues related to each of the summit objectives and discussed potential strategies to overcome these challenges. Twenty-one recommendations were derived: eleven recommendations focused on new approaches to incontinence research; eight on reinvigorating and repositioning nursing research on incontinence; and two on attracting and mentoring new investigators. CONCLUSIONS: The summit model used effectively engaged an international cadre of researchers and clinicians in stimulating discussions that yielded the identification of strategic directions for conducting and funding incontinence research and strategies for reinvigorating and repositioning nursing research on incontinence.

Aged↗
PubMedDate not supplied

Managing incontinence using technology, devices, and products: directions for research.

BACKGROUND: Millions of Americans with incontinence use some type of device or product to manage or collect urine or feces. However, research on their clinical uses, problems requiring nursing care, and patient satisfaction is lacking. OBJECTIVES: To review the various products and devices used for incontinence, identify directions for research and development on technology, and outline the ways nurses can influence and participate in those investigations. METHODS: Existing literature on incontinence technology, devices, and products was analyzed to generate a plan for future research. RESULTS: Gaps in knowledge exist about the uses, best practices, quality of life factors, and problems associated with catheters, absorbent products, other internal and external devices, and skin care products. CONCLUSIONS: Collaboration among public and private sectors would result in greater likelihood of high quality clinical research that has sufficient power and integrity, more efficient use of resources special to each setting, and expedited application of technologies for patient use.

Diapers, Adult↗