{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T08:23:53Z","timestamp":1793262233026,"version":"4.5.0"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T00:00:00Z","timestamp":1661990400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:sec>\n            <jats:title>PURPOSE:<\/jats:title>\n            <jats:p>The purpose of this study was to identify and describe the prevalence of incontinence (urinary and\/or fecal) and incontinence management practices among patients in US adult acute care settings, with and without hospital-acquired pressure injuries (HAPIs), using the data from the 2018\/2019 International Pressure Ulcer Prevalence\u2122 (IPUP) survey.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>DESIGN:<\/jats:title>\n            <jats:p>Observational, cohort study with cross-sectional data collection and retrospective data analysis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>SUBJECTS AND SETTING:<\/jats:title>\n            <jats:p>The sample comprised 296,014 patients hospitalized in 1801 acute care facilities in the United States that participated in 2018 and\/or 2019 IPUP survey. Of these, 192,852 (65%) patients had information recorded in the survey on incontinence status and were included in the analytical sample.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>Data from the 2018\/2019 IPUP database were analyzed to evaluate the prevalence of incontinence (urinary [UI], fecal [FI], and dual [DI]), and the use of incontinence and moisture management strategies. Incontinence prevalence was analyzed between 3 groups of patients: (1) those without pressure injuries; (2) patients with stage 1 and 2 HAPIs; and (3) those with severe HAPIs (stage 3, 4, unstageable, deep tissue pressure injury). Analysis of the subgroups within acute care was also undertaken and included medical-surgical, critical care, and step-down units.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>Incontinent patients were older (mean age 69-74 years depending on type of incontinence as compared to 62 years for continent patients) and had lower Braden Scale scores (range, 14.7-16.7, compared to 19.4 for continent patients). Half of the patients were female, 49.6% male, and 0.4% were unknown. Incontinence was identified in 32% of patients. Among patients with incontinence, 33% had UI, 12% had FI, and 55% had DI. Hospital-acquired pressure injuries were present in 27.4% of continent patients and 72.6% of incontinent patients, with DI having the highest rate of HAPIs. Analysis revealed a higher proportion of incontinent patients with unstageable HAPIs than continent patients (14.9% vs 9.6%, <jats:italic toggle=\"yes\">P<\/jats:italic> = .00), as well as a higher proportion of incontinent patients with deep tissue HAPIs as compared to continent patients (27.0% vs 22.1%, <jats:italic toggle=\"yes\">P<\/jats:italic> = .00). Significantly more incontinent patients regardless of HAPI status were using a bowel or bladder management system (<jats:italic toggle=\"yes\">P<\/jats:italic> = .00).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSION:<\/jats:title>\n            <jats:p>Results of this study support the importance of incontinence as a risk factor in HAPI development. The prevalence of all types of incontinence was 31.7% for the entire sample. Almost three-fourths (72.6%) of patients with HAPI had UF, FI, or DI. A standardized definition of both UI and FI is needed, given that over 70% of all critical care unit patients with a urinary catheter for incontinence management were still classified as urinary incontinent.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/won.0000000000000905","type":"journal-article","created":{"date-parts":[[2022,9,15]],"date-time":"2022-09-15T16:06:49Z","timestamp":1663258009000},"page":"405-415","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":10,"title":["Incontinence Management and Pressure Injury Rates in US Acute Care Hospitals"],"prefix":"10.1097","volume":"49","author":[{"given":"Kimberly","family":"Koloms","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill","family":"Cox","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine A.","family":"VanGilder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura E.","family":"Edsberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"2","key":"R1-20250806","doi-asserted-by":"crossref","first-page":"194","DOI":"10.3390\/ijerph16020194","article-title":"Urinary and fecal incontinence: point prevalence and predictors in a university hospital","volume":"16","author":"Condon","year":"2019","journal-title":"Int J Environ Res Public Health"},{"issue":"4","key":"R2-20250806","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1097\/WON.0000000000000548","article-title":"Examining prevalence and risk factors of incontinence-associated dermatitis using the International Pressure Ulcer Prevalence survey","volume":"46","author":"Kayser","year":"2019","journal-title":"J Wound Ostomy Continence 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survey","volume":"89","author":"Kayser","year":"2019","journal-title":"Int J Nurs Stud"},{"issue":"6","key":"R7-20250806","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1097\/WON.0000000000000818","article-title":"Incontinence and incontinence-associated dermatitis in acute care: a retrospective analysis of total cost of care and patient outcomes from the Premier Healthcare Database","volume":"48","author":"Kayser","year":"2021","journal-title":"J Wound Ostomy Continence Nurs"},{"key":"R8-20250806","doi-asserted-by":"crossref","first-page":"2","DOI":"10.4172\/2329-8847.1000156","article-title":"An overview of factors affecting the skin's Young's modulus","volume":"4","author":"Kalra","year":"2016","journal-title":"J Aging Sci."},{"issue":"2","key":"R9-20250806","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1111\/jan.12497","article-title":"Factors predicting the development of pressure ulcers in an at-risk population who receive standardized preventive care: secondary analyses of a multicentre randomised controlled trial","volume":"71","author":"Demarre","year":"2015","journal-title":"J Adv Nurs"},{"issue":"28","key":"R10-20250806","doi-asserted-by":"crossref","first-page":"1317","DOI":"10.1098\/rsif.2008.0034","article-title":"Influence of epidermal hydration on the friction of human skin against textiles","volume":"5","author":"Gerhardt","year":"2008","journal-title":"J R Soc Interface"},{"issue":"6","key":"R11-20250806","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1097\/WON.0000000000000704","article-title":"Interventions Post Catheter Removal (iPCaRe) in the acute care setting: an evidence- and consensus-based algorithm","volume":"47","author":"Gray","year":"2020","journal-title":"J Wound Ostomy Continence Nurs"},{"issue":"3","key":"R12-20250806","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1097\/WON.0000000000000431","article-title":"Assessment, selection, use, and evaluation of body-worn absorbent products for adults with incontinence: a WOCN Society Consensus Conference","volume":"45","author":"Gray","year":"2018","journal-title":"J Wound Ostomy Continence Nurs"},{"issue":"6","key":"R14-20250806","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1016\/j.iccn.2004.09.004","article-title":"Bowel management in the intensive care unit","volume":"20","author":"Dorman","year":"2004","journal-title":"Intensive Crit Care Nurs"},{"issue":"1","key":"R16-20250806","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1097\/WON.0000000000000390","article-title":"Incontinence-associated dermatitis, characteristics and relationship to pressure injury: a multisite epidemiologic analysis","volume":"45","author":"Gray","year":"2018","journal-title":"J Wound Ostomy Continence Nurs"},{"issue":"1","key":"R17-20250806","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1097\/WON.0000000000000834","article-title":"Pressure injuries in critical care patients in US hospitals: results of the International Pressure Ulcer Prevalence survey","volume":"49","author":"Cox","year":"2022","journal-title":"J Wound Ostomy Continence Nurs"},{"key":"R18-20250806","doi-asserted-by":"crossref","first-page":"102924","DOI":"10.1016\/j.iccn.2020.102924","article-title":"Predictors of pressure injury development in critically ill adults: a retrospective cohort study","volume":"62","author":"Sala","year":"2021","journal-title":"Intensive Crit Care Nurs"},{"issue":"2","key":"R19-20250806","first-page":"42","article-title":"A retrospective, descriptive, comparative study to identify patient variables that contribute to the development of deep tissue injury among patients in intensive care units","volume":"63","author":"Kirkland-Kyhn","year":"2017","journal-title":"Ostomy Wound Manage"},{"issue":"3","key":"R20-20250806","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1002\/nur.21593","article-title":"A systematic review and meta-analysis of incontinence-associated dermatitis, incontinence, and moisture as risk factors for pressure ulcer development","volume":"37","author":"Beeckman","year":"2014","journal-title":"Res Nurs Health"},{"issue":"3","key":"R21-20250806","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1097\/WON.0b013e318215f798","article-title":"Moisture-associated skin damage: overview and pathophysiology","volume":"38","author":"Gray","year":"2011","journal-title":"J Wound Ostomy Continence Nurs"},{"issue":"1","key":"R22-20250806","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.jtv.2016.02.004","article-title":"A decade of research on incontinence-associated dermatitis (IAD): evidence, knowledge gaps and next steps","volume":"26","author":"Beeckman","year":"2017","journal-title":"J Tissue Viability"},{"issue":"1","key":"R23-20250806","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1097\/WON.0b013e31823fe246","article-title":"Incontinence-associated dermatitis: a comprehensive review and update","volume":"39","author":"Gray","year":"2012","journal-title":"J Wound Ostomy Continence Nurs"},{"issue":"6","key":"R25-20250806","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1097\/WON.0000000000000381","article-title":"Do intra-anal bowel management devices reduce incontinence-associated dermatitis and\/or pressure injuries","volume":"44","author":"Beeson","year":"2017","journal-title":"J Wound Ostomy Continence Nurs"},{"issue":"4","key":"R26-20250806","article-title":"Expert recommendations for managing acute faecal incontinence with diarrhea in the intensive care unit","volume":"14","author":"Bayon Garcia","year":"2013","journal-title":"J Intensive Care Soc"}],"container-title":["Journal of Wound, Ostomy &amp; Continence Nursing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/WON.0000000000000905","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T15:01:26Z","timestamp":1754492486000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/WON.0000000000000905"}},"subtitle":["Analysis of Data From the 2018-2019 International Pressure Injury Prevalence\u2122 (IPUP) Survey"],"short-title":[],"issued":{"date-parts":[[2022,9]]},"references-count":22,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.1097\/won.0000000000000905","relation":{},"ISSN":["1071-5754"],"issn-type":[{"value":"1071-5754","type":"print"}],"subject":[],"published":{"date-parts":[[2022,9]]}}}