Incontinence Pad Culture; Hospital Wide Point Prevalence Study

Abstract Background Incontinence pads are widely used in hospitals, particularly during acute illness. When used correctly, pads support patient comfort, protect skin integrity, and assist those with genuine continence needs. This aligns with person-centred care, emphasising dignity, hygiene, and clinical necessity. However, inappropriate use—such as applying pads for staff convenience or on mobile patients—can lead to deconditioning, loss of continence, and diminished autonomy. The aim of this study was to assess the prevalence of incontinence aid use, as part of a wider service improvement project. Methods Data were gathered on all inpatients in a university hospital at a single timepoint. The Emergency Department and Intensive Care Unit were excluded. Incontinence aid usage and pre-admission usage was recorded, along with biographical data, catheter use, urinary incontinence status, and mobility status were gathered from medical notes. Results 187 patients were included in the study, of which 68.9% were over the age of 65 (n=129). Almost half of these wore continence pads (n=63), a fifth of which were new as inpatients. 30% of patients with continence pads had no documentation of pre-hospital status (n=19). The majority of these patients wearing pads were women (n=37). 47.7% of women over 65 had documented intermittent or persistent incontinence (31/64), vs 39.1% of men (25/65). On review, 21.9% of women were catheterised (14/64), in comparison to 26.2% of men (17/65). 22.2% of patients with pads were able to mobilise independently (n=10) or with a walking stick (n=4). 38.1% could mobilise with a Zimmer-frame (n=24). Conclusion This study demonstrates a large proportion of patients use incontinence pads in hospitals. This practice can undermine patient rehabilitation goals and reflect inadequate staff training or resource constraints. Reforming this culture involves shifting mindsets, improving education, and promoting alternatives such as prompted voiding or individualised toileting plans to support patient dignity, recovery, and long-term continence management.