The purpose of this proposal is to extend a prompted voiding incontinence management system that has been validated during daytime hours into the nighttime period. the nighttime incontinence management intervention is designed in consideration of a resident's sleep pattern, incontinence severity, and risk for pressure sore development. Extensive preliminary data collected by the investigative team and recent practice guidelines established by government expert panels for the management of incontinence and pressure sore prevention influenced the design of the intervention program. The intervention will be tested in 8 nursing homes over a period of four years using the multiple baseline delayed intervention design employed in our previous studies. Outcomes will be compared among residents in the immediate and delayed intervention nursing homes during three major phases: (1) both homes in baseline, (2) immediate home during intervention and delayed home still in baseline, and (3) both homes during intervention. Differences between the immediate and delayed intervention homes are hypothesized on measures of nighttime incontinence frequency and measures of sleep. In addition, daytime behavioral observations will be completed following nighttime monitoring of sleep to assess if improvements in nighttime incontinence and sleep are associated with improved resident daytime functioning.

National Institute of Health (NIH)
National Institute of Nursing Research (NINR)
Research Project (R01)
Project #
Application #
Study Section
Nursing Research Study Section (NURS)
Program Officer
Armstrong, Nell
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Budget Start
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Fiscal Year
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University of California Los Angeles
Internal Medicine/Medicine
Schools of Medicine
Los Angeles
United States
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Ouslander, J G; Ai-Samarrai, N; Schnelle, J F (2001) Prompted voiding for nighttime incontinence in nursing homes: is it effective? J Am Geriatr Soc 49:706-9
Ouslander, J; Johnson, T; Nasr, S et al. (1999) Atrial natriuretic peptide levels in geriatric patients with nocturia and nursing home residents with nighttime incontinence. J Am Geriatr Soc 47:1439-44
Schnelle, J F; Alessi, C A; Al-Samarrai, N R et al. (1999) The nursing home at night: effects of an intervention on noise, light, and sleep. J Am Geriatr Soc 47:430-8
Schnelle, J F; Cruise, P A; Alessi, C A et al. (1998) Sleep hygiene in physically dependent nursing home residents: behavioral and environmental intervention implications. Sleep 21:515-23
Cruise, P A; Schnelle, J F; Alessi, C A et al. (1998) The nighttime environment and incontinence care practices in nursing homes. J Am Geriatr Soc 46:181-6
Schnelle, J F; Cruise, P A; Alessi, C A et al. (1998) Individualizing nighttime incontinence care in nursing home residents. Nurs Res 47:197-204
Ouslander, J G; Nasr, S Z; Miller, M et al. (1998) Arginine vasopressin levels in nursing home residents with nighttime urinary incontinence. J Am Geriatr Soc 46:1274-9
Ouslander, J G; Buxton, W G; Al-Samarrai, N R et al. (1998) Nighttime urinary incontinence and sleep disruption among nursing home residents. J Am Geriatr Soc 46:463-6
Schnelle, J F; Adamson, G M; Cruise, P A et al. (1997) Skin disorders and moisture in incontinent nursing home residents: intervention implications. J Am Geriatr Soc 45:1182-8
Alessi, C A; Schnelle, J F; Traub, S et al. (1995) Psychotropic medications in incontinent nursing home residents: association with sleep and bed mobility. J Am Geriatr Soc 43:788-92

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