부산대학교 도서관

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] : n = 849), after the 6-month implementation period (T[sub.1] : n = 740), and after a 6-month maintenance period (T[sub.2] : n = 709). The records of symptomatic inpatients were audited for continence assessment, diagnosis, and management plans. All wards contributed data at T[sub.0] , and 11/15 wards contributed at T[sub.1] and T[sub.2] (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] : n = 283, T[sub.1] : n = 241, T[sub.2] : n = 256) receiving recommended care were: assessment T[sub.0] = 38%, T[sub.1] = 63%, T[sub.2] = 68%; diagnosis T[sub.0] = 30%, T[sub.1] = 70%, T[sub.2] = 71%; management plan T[sub.0] = 7%, T[sub.1] = 24%, T[sub.2] = 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] . This intervention has improved inpatient continence care.
Author(s): Dianne Lesley Marsden (corresponding author) [1,2,3,*]; Kerry Boyle [1,2,4]; Jaclyn Birnie [5]; Amanda Buzio [6]; Joshua Dizon [3]; Judith Dunne [7,8]; Sandra Greensill [9]; Kelvin Hill [10]; Sandra Lever [...]