Assessment Of Hospital-acquired Incontinence In An Acute Hospital: A Re-audit
Bibliographic record
Abstract
Abstract Background Urinary incontinence is a common problem in older adults. Hospital-acquired incontinence can result in increased morbidity and increased length of stay. The aim of this audit was to assess hospital-acquired incontinence in older adults in an acute hospital. Methods This audit and re-audit was guided by Royal College of Physicians (RCP) National Audit of Continence Care (NACC) standard. A prospective audit was carried out over a three-day period on general medical and surgical wards at the beginning of continence awareness month. Nursing notes and medical charts on all patients over 65 years old were reviewed for documentation of continence status pre-admission, inpatient continence status, continence wear and reason for continence wear. A re-audit was conducted eight weeks later. Results All patients had a documented continence status. Fifty-nine patients were included in the initial audit. Forty-four were continent preadmission. Of these, twelve had documented incontinence wear as inpatients. Documented rationale for incontinence wear included frequency (n=2) secondary to [urinary tract infection (UTI) (n=1), and not documented (n=1)], mixed continence (n=1), cognition (n=1), mobility (n=7) and not documented (n=1). Sixty-eight patients were included in a re-audit. Forty patients were continent preadmission. Among them, fourteen had documented incontinence wear as an inpatient. Documented rationale for incontinence wear included frequency (n=1) with no documented reason, acutely unwell (n=1), cognition (n=5), mobility (n=3), reassurance (n=2) and not documented (n=2). Conclusion Although continence status was well documented, a significant number of patients who were continent pre-admission were using incontinence wear as inpatients. The rationale for incontinence wear varied significantly. The increase in incontinence wear usage between audits highlights the need for sustained proactive identification of patients at high risk for hospital-acquired incontinence. Future projects should focus on continence promotion strategies in this population, quality improvement and education of appropriate use of incontinence wear to mitigate these risks.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.016 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".