Improving Practice for Urinary Continence Care on Adult Acute Medical and Rehabilitation Wards: A Multi-Site, Co-Created Implementation Study
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 eva...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-04-01
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| Series: | Healthcare |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2227-9032/11/9/1241 |
| _version_ | 1797602639965323264 |
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| author | Dianne Lesley Marsden Kerry Boyle Jaclyn Birnie Amanda Buzio Joshua Dizon Judith Dunne Sandra Greensill Kelvin Hill Sandra Lever Fiona Minett Sally Ormond Jodi Shipp Jennifer Steel Amanda Styles John Wiggers Dominique Ann-Michele Cadilhac Jed Duff |
| author_facet | Dianne Lesley Marsden Kerry Boyle Jaclyn Birnie Amanda Buzio Joshua Dizon Judith Dunne Sandra Greensill Kelvin Hill Sandra Lever Fiona Minett Sally Ormond Jodi Shipp Jennifer Steel Amanda Styles John Wiggers Dominique Ann-Michele Cadilhac Jed Duff |
| author_sort | Dianne Lesley Marsden |
| collection | DOAJ |
| description | 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 (T<sub>0</sub>: n = 849), after the 6-month implementation period (T<sub>1</sub>: n = 740), and after a 6-month maintenance period (T<sub>2</sub>: n = 709). The records of symptomatic inpatients were audited for continence assessment, diagnosis, and management plans. All wards contributed data at T<sub>0</sub>, and 11/15 wards contributed at T<sub>1</sub> and T<sub>2</sub> (dropouts due to COVID-19). Approximately 26% of stroke, 33% acute medical, and 50% of rehabilitation inpatients were symptomatic. The proportions of symptomatic patients (T<sub>0</sub>: n = 283, T<sub>1</sub>: n = 241, T<sub>2</sub>: n = 256) receiving recommended care were: assessment T<sub>0</sub> = 38%, T<sub>1</sub> = 63%, T<sub>2</sub> = 68%; diagnosis T<sub>0</sub> = 30%, T<sub>1</sub> = 70%, T<sub>2</sub> = 71%; management plan T<sub>0</sub> = 7%, T<sub>1</sub> = 24%, T<sub>2</sub> = 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 T<sub>2</sub>. This intervention has improved inpatient continence care. |
| first_indexed | 2024-03-11T04:18:21Z |
| format | Article |
| id | doaj.art-aea95243d5dd4431a1e2c3a541562109 |
| institution | Directory Open Access Journal |
| issn | 2227-9032 |
| language | English |
| last_indexed | 2024-03-11T04:18:21Z |
| publishDate | 2023-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Healthcare |
| spelling | doaj.art-aea95243d5dd4431a1e2c3a5415621092023-11-17T22:57:16ZengMDPI AGHealthcare2227-90322023-04-01119124110.3390/healthcare11091241Improving Practice for Urinary Continence Care on Adult Acute Medical and Rehabilitation Wards: A Multi-Site, Co-Created Implementation StudyDianne Lesley Marsden0Kerry Boyle1Jaclyn Birnie2Amanda Buzio3Joshua Dizon4Judith Dunne5Sandra Greensill6Kelvin Hill7Sandra Lever8Fiona Minett9Sally Ormond10Jodi Shipp11Jennifer Steel12Amanda Styles13John Wiggers14Dominique Ann-Michele Cadilhac15Jed Duff16Hunter Stroke Service, Hunter New England Local Health District, New Lambton Heights, NSW 2305, AustraliaHunter Stroke Service, Hunter New England Local Health District, New Lambton Heights, NSW 2305, AustraliaArmidale Hospital, Hunter New England Local Health District, Armidale, NSW 2350, AustraliaCoffs Harbour Health Campus, Mid North Coast Local Health District, Coffs Harbour, NSW 2450, AustraliaHunter Medical Research Institute, New Lambton Heights, NSW 2305, AustraliaRankin Park Centre, Hunter New England Local Health District, New Lambton Heights, NSW 2305, AustraliaRockhampton Hospital, Central Queensland Hospital and Health Service, Rockhampton, QLD 4700, AustraliaStroke Foundation, Melbourne, VIC 3000, AustraliaRyde Hospital, Northern Sydney Local Health District, Eastwood, NSW 2122, AustraliaManning Hospital, Hunter New England Local Health District, Taree, NSW 2430, AustraliaHunter Stroke Service, Hunter New England Local Health District, New Lambton Heights, NSW 2305, AustraliaRankin Park Centre, Hunter New England Local Health District, New Lambton Heights, NSW 2305, AustraliaPort Macquarie Hospital, Mid North Coast Local Health District, Port Macquarie, NSW 2444, AustraliaArmidale Hospital, Hunter New England Local Health District, Armidale, NSW 2350, AustraliaCollege of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, AustraliaStroke and Ageing Research, Faculty of Medicine, Nursing and Health Sciences, School of Clinical Sciences at Monash Health, Clayton, VIC 3168, AustraliaCollege of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, AustraliaMany 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 (T<sub>0</sub>: n = 849), after the 6-month implementation period (T<sub>1</sub>: n = 740), and after a 6-month maintenance period (T<sub>2</sub>: n = 709). The records of symptomatic inpatients were audited for continence assessment, diagnosis, and management plans. All wards contributed data at T<sub>0</sub>, and 11/15 wards contributed at T<sub>1</sub> and T<sub>2</sub> (dropouts due to COVID-19). Approximately 26% of stroke, 33% acute medical, and 50% of rehabilitation inpatients were symptomatic. The proportions of symptomatic patients (T<sub>0</sub>: n = 283, T<sub>1</sub>: n = 241, T<sub>2</sub>: n = 256) receiving recommended care were: assessment T<sub>0</sub> = 38%, T<sub>1</sub> = 63%, T<sub>2</sub> = 68%; diagnosis T<sub>0</sub> = 30%, T<sub>1</sub> = 70%, T<sub>2</sub> = 71%; management plan T<sub>0</sub> = 7%, T<sub>1</sub> = 24%, T<sub>2</sub> = 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 T<sub>2</sub>. This intervention has improved inpatient continence care.https://www.mdpi.com/2227-9032/11/9/1241urinary incontinencelower urinary tract symptomsinpatientpatient care planningprofessional practice gapsevidence-based practice |
| spellingShingle | Dianne Lesley Marsden Kerry Boyle Jaclyn Birnie Amanda Buzio Joshua Dizon Judith Dunne Sandra Greensill Kelvin Hill Sandra Lever Fiona Minett Sally Ormond Jodi Shipp Jennifer Steel Amanda Styles John Wiggers Dominique Ann-Michele Cadilhac Jed Duff Improving Practice for Urinary Continence Care on Adult Acute Medical and Rehabilitation Wards: A Multi-Site, Co-Created Implementation Study Healthcare urinary incontinence lower urinary tract symptoms inpatient patient care planning professional practice gaps evidence-based practice |
| title | Improving Practice for Urinary Continence Care on Adult Acute Medical and Rehabilitation Wards: A Multi-Site, Co-Created Implementation Study |
| title_full | Improving Practice for Urinary Continence Care on Adult Acute Medical and Rehabilitation Wards: A Multi-Site, Co-Created Implementation Study |
| title_fullStr | Improving Practice for Urinary Continence Care on Adult Acute Medical and Rehabilitation Wards: A Multi-Site, Co-Created Implementation Study |
| title_full_unstemmed | Improving Practice for Urinary Continence Care on Adult Acute Medical and Rehabilitation Wards: A Multi-Site, Co-Created Implementation Study |
| title_short | Improving Practice for Urinary Continence Care on Adult Acute Medical and Rehabilitation Wards: A Multi-Site, Co-Created Implementation Study |
| title_sort | improving practice for urinary continence care on adult acute medical and rehabilitation wards a multi site co created implementation study |
| topic | urinary incontinence lower urinary tract symptoms inpatient patient care planning professional practice gaps evidence-based practice |
| url | https://www.mdpi.com/2227-9032/11/9/1241 |
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