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Innovative Incontinence Care promotes better sleep and reduces the number of falls

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Clinical study supports updating long-term care practices

ROCK HILL, S.C., June 4, 2014 /PRNewswire/ -- After five years of continuous refinement, Dignity Continence Solutions now creates permanent behavior change that supports natural sleep patterns and improves outcomes.

Clinicians know that incontinence related moisture often results in skin irritation and breakdown1,2. To combat these negative effects, caregivers routinely check and change absorbent products up to nine times a day. However, this practice compromises the resident's dignity, independence and most of all, their natural sleep patterns. Dignity Continence Solutions (DCS) by HARTMANN USA, Inc. offers a new care protocol that restores a good night's sleep and protects resident dignity and comfort. Utilizing more absorbent products and fewer of them reduces the amount of disruptive and embarrassing product changes, without compromising skin health or the rate of UTI's. Additionally, a comprehensive training program promotes the necessary behavior change among staff, through the use of one-on-one consultancy, specialized tools and products. The program has been refined over five years and is based on the scientific findings on how to bring about long-term behavior change through consultancy. A clinical outcomes study was conducted and independently verified to demonstrate the benefits of this innovative protocol.

Study design
This outcomes study was based on Minimum Data Set (MDS) 2.0 data for a total of 268 residents from July 2009 through July 2010. The residents included in the study lived in 16 long-term care communities from the Presbyterian Manors of Mid America Group. Independent researcher Christie Teigland analyzed the MDS data to determine the physical and mental health-related outcomes of residents following the DCS care protocol.

Mental Health Outcomes
Several improvements in depression indicators provided exciting and unexpected results. Although depression indicators in the nursing home population typically increase, the indicators during the intervention period showed a decrease. The percentage of residents with repetitive complaints declined by 33.0% in the intervention period, compared to the control period that increased by 9.4%. Teigland explained that, "the intervention has significantly reduced these types of complaints in residents treated under the new protocol." Compared to the control period, 62.9% fewer residents in the intervention period possessed the depression indicator of unpleasant mood in the morning. This finding is directly related to the residents' ability to sleep soundly through the night and to choose their own waking time.

Researchers also identified a reduction in the number of repetitive questions and the instances of crying/tearfulness. While this reduction was not statistically significant, it does represent an encouraging trend.

Physical Health Outcomes
Despite reducing product changes by half, neither the rate of UTIs nor the rate of pressure ulcers increased during the intervention period. In her report of the study outcomes, researcher Christie Teigland said, "A primary [concern] expressed by the nursing staffs was that the new incontinence protocol may result in an increase in UTIs, which is a quality issue for residents. This did not prove to be true based on the data."

While the rate of pressure ulcers and UTIs remained unchanged, the rate of falls decreased by 28.4% in the intervention period. Teigland pointed out that "falls represent a serious quality of life issue, leading to functional and cognitive decline and depression, and result in significantly higher healthcare costs." In describing the link between better sleep and fewer falls, Teigland stated that getting more sleep is "likely to contribute to fewer falls - i.e., not getting up and trying to move around on their own at night and [being] more alert during the daytime hours."

This clinical outcomes study provides evidence that supports a person-centered approach to adult incontinence care. With DCS, clinicians can offer an incontinence care protocol that protects residents' sleep and dignity, and considers the resident's individual needs and wishes without compromising skin health.

DCS presented the results of this study at the 2012 Pioneer National Conference and the 2012 LeadingAge National Conference as well as at other state coalition conferences of Pioneer, LeadingAge and NADONA through 2014. The data for this study is on file; for more information, call 1-888-932-3275.

About Dignity Continence Solutions
Dignity Continence Solutions is a revolutionary person-centered incontinence management program that focuses on protecting residents' dignity and sleep patterns by decreasing the number of embarrassing product changes. DCS is focused on achieving culture-change in long-term care by partnering with communities to individualize incontinence care plans while realizing total expenditure reductions.

HARTMANN USA manufactures and markets high-performance product solutions in the areas of Incontinence, Compression and Wound Management. With nearly two centuries of design, development and distribution experience, HARTMANN supports healthcare professionals across the continuum of care and partners with customers to enhance residents' quality of life. More online: or by phone:  1-800-243-2294.

Dignity Continence Solutions is a registered trademark of HARTMANN USA, Inc.

1 Gray M. Incontinence-related skin damage: essential knowledge. Ostomy Wound Management. 2007;53:28-32
2 Beeckmean D, Schoonhoven L, Verhaeghe S, Heyneman A, Defloor T. Prevention and treatment of incontinence-associated dermatitis: literature review. J Adv Nurs.  2009;65:1141-1154

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