Updated: Mar 27
Urinary Incontinence (UI), Urgency Urinary Incontinence (UUI), and Overactive Bladder (OAB) have direct impacts on care costs and staff turnover in long-term care settings. Approximately 36% of resident falls occurred while attempting to get to the bathroom, and a majority of DONs reported that UI management contributes to certified nursing assistant (CNA) turnover. In this blog we will discuss the impact of UI and OAB in long-term care, and how the BreatheDRY absorbent pad can help to minimize many of these impacts, benefiting your residents, your caregivers, and your operating expenses.
UUI has a higher prevalence in long-term care settings than in the general public with 65% - 70% of individuals over the age of 65 in long-term care settings reporting not being in complete control of their bladder function. A survey of DON’s from long-term care organizations showed that of the 62% of residents with UI, 81% used products for their incontinence. Likewise, approximately 89% of residents need assistance in toileting. This has a direct effect on resident care, ADLs, safety, staffing levels, cost of care, and quality of life.
Safety Risks of UI and OAB
One of the biggest safety risks is falls related to incontinence. A survey of long-term care facilities noted that 35.7% of falls per month occurred while trying to get to the bathroom. These falls triggered a care plan review in 91.5% of residents with an average of 8.5 staff members involved in meetings and follow up for a fall incident. On average, the total time spent on care plans post-fall was 2.3 hours (incurring several hundred dollars in labor costs). In addition, DONs reported that 26.3% of skin rashes and 30.9% of skin infections that developed as a result of urine wetness required medical treatment. These resulting conditions can have a direct impact on an organization’s quality rating with the Centers for Medicare and Medicaid Services (CMS). Areas the CMS measures related to UI include the percentage of residents experiencing one or more falls with major injury, experiencing a UTI, needing increased help for activities of daily living (ADLs), and high-risk residents with pressure ulcers.
Protecting Skin Integrity
The BreatheDRY Absorbent pad can help. It’s a white, soft flat sheet with an absorbent layer and a waterproof breathable underside that stops fluid from getting through to the surface below and wicks away moisture to protect the resident’s skin. BreatheDRY was designed to be breathable, manage climate control, and preserve skin integrity. Its breathable backing permits air flow yet prevents leakage onto the linen or whatever surface it is placed upon. BreatheDRY Absorbent Pads are compatible with all pressure redistribution surfaces, including low air loss mattress therapy, and are twenty (20) times more breathable than traditional blue underpads. An independent pressure study proved that there was no additional pressure load on a resident’s skin when using BreatheDRY.  The TIP maps below show some results of the study.
Tissue Interface Pressure Mapping with no Absorbent Pad (55 pounds)
Tissue Interface Pressure Mapping with BreatheDRY Pad (55 pounds)
Keeps Skin Dry and Reduces Odors
BreatheDRY preserves the microclimate of the skin (the moisture balance of skin) and helps to reduce the risk of moisture related skin damage thus maintaining skin integrity. The BreatheDRY pad draws in moisture, locks it away from the skin and feels dry to the touch in just minutes. In fact, 99.87% of moisture is locked in after five minutes. It also reduces odors due to highly absorbent polymers encapsulated in the core. The BeatheDRY dries faster and is drier overall when compared to traditional disposable bed pads and reusable bed pads.
Impact on Staffing, Laundry, and Product Costs
OAB and UI also significantly impact staff burden and other care costs in long-term care facilities including the costs of laundry, incontinence products, linen changes, and resident cleanup. Incontinence products were checked for wetness every 2.5 hours, and 5.6% of DONs reported that staff always changed incontinence products, even if residents were dry. On average, $5,407 are spent monthly on incontinence products, while monthly laundering costs average $5,497.
CNAs performed most of the changes and spent 56.4% of their time managing incontinence needs. Per shift, CNAs changed an average of 36.6 incontinence products and assisted with an average of 25.5 toileting episodes, taking 12.1 and 12.9 minutes per episode, respectively. Per shift, staff performed an average of 1.7 bed linen changes owing to wetting accidents. This is a direct contributor to CNA turnover with 59.2% of DONs reporting dissatisfaction with management of incontinence to be a cause of CNA turnover. High turnover can result in lack of familiarity with residents, organization protocols, and can lead to a decline in quality of care, not to mention increased staffing costs from recruitment, training, and turnover.
Your costs are reduced with BreatheDRY protecting your bedding and patient slings. This results in less linen changes per shift, and lower laundry expenses. The high level fluid handling capacity of the BreatheDRY Standard absorbs 3.2 liters per m2 (AWTA 62), and the BreatheDRY Protect absorbs 6.4 liters, which assists the containment and safe disposal through control of fluids. Not only does this reduce your number of linen changes, but it also reduces your cost of products because the BreatheDRY can be used multiple times before changing due to its high absorbency capacity, drying rate, and odor reduction. The pad typically costs less than the cost to machine wash linens and reusable bed pads. Less time spent on changing incontinence products can boost staff morale and contribute towards lower turnover rates, thus reducing your recruiting, hiring, and training costs, while maintaining higher levels of care. Let us know if you would like to see for yourself. We are happy to schedule a time to visit with you, and provide a demonstration on how the BreatheDry can help your residents, your caregivers, and your organization.
 Gorina, Y., Schappert, S., Bercovitz, A., Elgaddal, N., & Kramarow, E.: Prevalence of Incontinence Among Older Americans. Vital and Health Statistics. Series 3, Analytical and Epidemiological Studies, 2014; (36), 1–33. PMID:24964267  Stefancci, Richard G., Yeaw, Jason, Shah, Drishti, Newman, Diane K., Kincaid, Amy, Mudd, Paul: Impact of Urinary Incontinence Related to Overactive Bladder on Long-Term Care Residents and Facilities: A Perspective From Directors of Nursing. Journal of Gerontological Nursing, 2022, Vol 48, No 7; 38-46.  Harris-Kojetin, L., Sengupta, M., Lendon, J. P., Rome, V., Valverde, V., & Caff rey, C.: Long-term Care Providers and Services Users in the United States, 2015–2016. Vital Health Statistics, 2019: 3(43), 1–78.  Stefancci, Richard G., Yeaw, Jason, Shah, Drishti, Newman, Diane K., Kincaid, Amy, Mudd, Paul: Impact of Urinary Incontinence Related to Overactive Bladder on Long-Term Care Residents and Facilities: A Perspective From Directors of Nursing. Journal of Gerontological Nursing, 2022, Vol 48, No 7; 38-46  IBID  The BreatheDRY® pads have no adverse effect on the pressure on a resident’s skin, and won’t contribute to pressure ulcers. An Independent Pressure study proved little difference in pressure load to a patient when lying on a BreatheDRY®, when compared to no bed pad at all. Tests were conducted at 55 lb., 110lb., and 220 lb. The blue patterns indicates where pressure occurs.  Stefancci, Richard G., Yeaw, Jason, Shah, Drishti, Newman, Diane K., Kincaid, Amy, Mudd, Paul: Impact of Urinary Incontinence Related to Overactive Bladder on Long-Term Care Residents and Facilities: A Perspective From Directors of Nursing. Journal of Gerontological Nursing, 2022, Vol 48, No 7; 38-46.  IBID  Lerner, N. B., Johantgen, M., Trinkoff , A. M., Storr, C. L., & Han, K. (2014). Are Nursing Home Survey Deficiencies Higher in Facilities with Greater Staff Turnover?. Journal of the American Medical Directors Association, 2014: 15(2), 102–107. https://doi.org/10.1016/j.jamda.2013.09.003 PMID:24139163