Urinary incontinence affects 50–70% of skilled nursing facility residents, and fecal incontinence occurs in 33–50%. Beyond the dignity implications, incontinence drives moisture-associated skin damage (MASD), pressure injury risk, urinary tract infection, and significant supply expenditure. The average SNF spends $8,000–$12,000 annually per resident on incontinence-related supplies and labor. Effective management requires the right products, individualized resident assessment, and staff training in evidence-based continence care. Our incontinence product catalog includes over 27,000 items from Medline, Hartmann, Cardinal Health, and Attends.
Containment Product Selection
Incontinence product selection should match functional incontinence type and severity — not default to the highest-absorbency product for every resident. Over-specification drives cost without improving resident comfort or skin outcomes. A resident with urge incontinence who voids every 2 hours requires a lighter-absorbency product than one with functional incontinence who cannot toilet independently. Product categories include: adult briefs (maximum absorbency, for heavy incontinence in non-ambulatory residents), pull-on style underwear (for ambulatory or semi-ambulatory residents), bladder control pads (for light-to-moderate incontinence in continent women), male guards (for light incontinence in male residents), underpads/Chux (bed protection), and external urinary catheters (for male residents with functional incontinence).
Prompted Voiding Programs
Prompted voiding (PV) — a behavioral intervention in which staff check residents every 2 hours, ask about continence, prompt toileting, and provide positive reinforcement — reduces incontinent episodes by 25–40% in appropriate residents. CMS requires individualized care plans addressing continence management and considers prompted voiding programs a quality indicator in the MDS 3.0. Residents appropriate for PV are those who can self-report bladder sensation and cooperate with toileting — approximately 25% of SNF residents. For the remaining 75%, scheduled toileting, habit training, or containment-only strategies are appropriate based on resident capacity.
Skin Care Integration
Incontinence-associated dermatitis (IAD) — the inflammatory skin response to prolonged contact with urine and feces — affects 5.6–50% of incontinent residents and is the primary precursor to pressure injury in the sacral/perineal region. Structured skin care using pH-balanced no-rinse cleansers, moisture barrier products (zinc oxide, petrolatum, or dimethicone-based), and regular skin assessment reduces IAD incidence by 30–59% in RCTs. Our skin care catalog and incontinence supplies together provide a complete IAD prevention formulary. Medline Remedy Phytoplex, Coloplast Baza Protect, and ConvaTec Sensi-Care barrier products are available in bulk with facility pricing.
External Urinary Catheters: A Safer Alternative to Foley
Indwelling urinary catheters (Foley catheters) are associated with catheter-associated UTI (CAUTI) — the most common healthcare-associated infection. Each day of Foley catheterization adds approximately 3–7% daily CAUTI risk. External urinary catheters (condom catheters for men, newer female external urinary catheters from PureWick) provide containment without invasive urinary tract entry and are now recommended by SHEA and APIC as preferred alternatives for incontinent patients who do not require urinary monitoring. Our urology catalog includes both traditional and newer female external catheter systems.
