TY - JOUR
T1 - Improving Practice for Urinary Continence Care on Adult Acute Medical and Rehabilitation Wards
T2 - A Multi-Site, Co-Created Implementation Study
AU - Marsden, Dianne Lesley
AU - Boyle, Kerry
AU - Birnie, Jaclyn
AU - Buzio, Amanda
AU - Dizon, Joshua
AU - Dunne, Judith
AU - Greensill, Sandra
AU - Hill, Kelvin
AU - Lever, Sandra
AU - Minett, Fiona
AU - Ormond, Sally
AU - Shipp, Jodi
AU - Steel, Jennifer
AU - Styles, Amanda
AU - Wiggers, John
AU - Cadilhac, Dominique Ann Michele
AU - Duff, Jed
AU - on behalf of the I-SCAMP Project Team
N1 - Funding Information:
Funding: This research was supported by the Hunter Stroke Service (Hunter New England Local Health District). The project received small project grants from: the Hunter New England Local Health District Improvement Grant and statistical support grant, NSW Agency for Clinical Innovation Research Grant Scheme, Priority Research Centre for Stroke and Brain Injury (University of Newcastle), and NSW Nursing and Midwifery Strategy Reserve Funding. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.
Funding Information:
Conflicts of Interest: Authors D.L.M., K.B., J.B., A.B., J.D. (Judith Dunne), F.M., S.O., M.P., J.S. (Jodi Shipp), S.L., J.S. (Jennifer Steel), A.S., and J.W. are employees of NSW Health (New South Wales, Australia). S.G. is an employee of Queensland Health (Queensland Australia). K.H. is an employee of the Stroke Foundation. J.D. (Joshua Dizon) is an employee of the Hunter Medical Research Institute. J.D. (Jed Duff) is an employee of Queensland University of Technology and worked for the University of Newcastle during the study, where he now is a conjoint professor. D.A.-M.C. receives a Senior Research Fellowship from the National Health and Medical Research Council (1154273).
Publisher Copyright:
© 2023 by the authors.
PY - 2023/5
Y1 - 2023/5
N2 - Many adult inpatients experience urinary continence issues; however, we lack evidence on effective interventions for inpatient continence care. We conducted a before and after implementation study. We implemented our guideline-based intervention using strategies targeting identified barriers and evaluated the impact on urinary continence care provided by inpatient clinicians. Fifteen wards (acute = 3, rehabilitation = 7, acute and rehabilitation = 5) at 12 hospitals (metropolitan = 4, regional = 8) participated. We screened 2298 consecutive adult medical records for evidence of urinary continence symptoms over three 3-month periods: before implementation (T0: n = 849), after the 6-month implementation period (T1: n = 740), and after a 6-month maintenance period (T2: n = 709). The records of symptomatic inpatients were audited for continence assessment, diagnosis, and management plans. All wards contributed data at T0, and 11/15 wards contributed at T1 and T2 (dropouts due to COVID-19). Approximately 26% of stroke, 33% acute medical, and 50% of rehabilitation inpatients were symptomatic. The proportions of symptomatic patients (T0: n = 283, T1: n = 241, T2: n = 256) receiving recommended care were: assessment T0 = 38%, T1 = 63%, T2 = 68%; diagnosis T0 = 30%, T1 = 70%, T2 = 71%; management plan T0 = 7%, T1 = 24%, T2 = 24%. Overall, there were 4-fold increased odds for receiving assessments and management plans and 6-fold greater odds for diagnosis. These improvements were sustained at T2. This intervention has improved inpatient continence care.
AB - Many adult inpatients experience urinary continence issues; however, we lack evidence on effective interventions for inpatient continence care. We conducted a before and after implementation study. We implemented our guideline-based intervention using strategies targeting identified barriers and evaluated the impact on urinary continence care provided by inpatient clinicians. Fifteen wards (acute = 3, rehabilitation = 7, acute and rehabilitation = 5) at 12 hospitals (metropolitan = 4, regional = 8) participated. We screened 2298 consecutive adult medical records for evidence of urinary continence symptoms over three 3-month periods: before implementation (T0: n = 849), after the 6-month implementation period (T1: n = 740), and after a 6-month maintenance period (T2: n = 709). The records of symptomatic inpatients were audited for continence assessment, diagnosis, and management plans. All wards contributed data at T0, and 11/15 wards contributed at T1 and T2 (dropouts due to COVID-19). Approximately 26% of stroke, 33% acute medical, and 50% of rehabilitation inpatients were symptomatic. The proportions of symptomatic patients (T0: n = 283, T1: n = 241, T2: n = 256) receiving recommended care were: assessment T0 = 38%, T1 = 63%, T2 = 68%; diagnosis T0 = 30%, T1 = 70%, T2 = 71%; management plan T0 = 7%, T1 = 24%, T2 = 24%. Overall, there were 4-fold increased odds for receiving assessments and management plans and 6-fold greater odds for diagnosis. These improvements were sustained at T2. This intervention has improved inpatient continence care.
KW - evidence-based practice
KW - hospital
KW - implementation science
KW - inpatient
KW - lower urinary tract symptoms
KW - nursing process
KW - patient care planning
KW - professional practice gaps
KW - quality improvement
KW - urinary incontinence
UR - http://www.scopus.com/inward/record.url?scp=85159359789&partnerID=8YFLogxK
U2 - 10.3390/healthcare11091241
DO - 10.3390/healthcare11091241
M3 - Article
C2 - 37174783
AN - SCOPUS:85159359789
SN - 2227-9032
VL - 11
JO - Healthcare
JF - Healthcare
IS - 9
M1 - 1241
ER -
