Effectiveness of conservative urinary incontinence management among female nursing home residents-A cluster RCT.


Journal

Archives of gerontology and geriatrics
ISSN: 1872-6976
Titre abrégé: Arch Gerontol Geriatr
Pays: Netherlands
ID NLM: 8214379

Informations de publication

Date de publication:
Historique:
received: 09 07 2018
revised: 03 12 2018
accepted: 17 01 2019
pubmed: 27 1 2019
medline: 1 1 2020
entrez: 27 1 2019
Statut: ppublish

Résumé

Guideline-compliant conservative management of urinary incontinence (UI) is the first step of the initial management for UI and is recommended for long-term care in older persons. Recent studies have focused on the effects of guideline-compliant UI management. However, most of these studies were tested in another setting than nursing homes and were not focused on conservative management. To measure the effectiveness of 29 evidence-based nursing recommendations regarding the conservative management of UI in Austrian nursing homes. The study is a cluster randomized intervention trial with institution as the unit of randomization. Twelve nursing homes in two Austrian provinces (Styria, Carinthia) were randomly allocated to the intervention group (IG) and control group (CG). Data were collected from participating residents over a three-month period. The intervention consisted of the implementation of recommendations for the conservative management of UI among female nursing home residents. The primary outcome variable was the daily UI experienced by the participating residents. Residents in the (IG n = 216) had a lower risk (OR = 0.14, p = 0.02) of experiencing daily UI and were less likely to receive absorbent products (OR = 0.01, p = 0.01) than residents in the CG (n = 165). Residents in the IG (OR = 5.16, p = 0.00) were five times more likely to receive recommended interventions (e.g., bladder training) than residents in the CG. Introducing guideline-compliant management into nursing practice can increase the likelihood of evidence-based interventions for the conservative management of UI. The intervention in this study targeted on nurses/nurse managers and can be recommended for the nursing home setting.

Sections du résumé

BACKGROUND
Guideline-compliant conservative management of urinary incontinence (UI) is the first step of the initial management for UI and is recommended for long-term care in older persons. Recent studies have focused on the effects of guideline-compliant UI management. However, most of these studies were tested in another setting than nursing homes and were not focused on conservative management.
AIMS
To measure the effectiveness of 29 evidence-based nursing recommendations regarding the conservative management of UI in Austrian nursing homes.
METHODS
The study is a cluster randomized intervention trial with institution as the unit of randomization. Twelve nursing homes in two Austrian provinces (Styria, Carinthia) were randomly allocated to the intervention group (IG) and control group (CG). Data were collected from participating residents over a three-month period. The intervention consisted of the implementation of recommendations for the conservative management of UI among female nursing home residents. The primary outcome variable was the daily UI experienced by the participating residents.
RESULTS
Residents in the (IG n = 216) had a lower risk (OR = 0.14, p = 0.02) of experiencing daily UI and were less likely to receive absorbent products (OR = 0.01, p = 0.01) than residents in the CG (n = 165). Residents in the IG (OR = 5.16, p = 0.00) were five times more likely to receive recommended interventions (e.g., bladder training) than residents in the CG.
CONCLUSION
Introducing guideline-compliant management into nursing practice can increase the likelihood of evidence-based interventions for the conservative management of UI. The intervention in this study targeted on nurses/nurse managers and can be recommended for the nursing home setting.

Identifiants

pubmed: 30684769
pii: S0167-4943(19)30004-4
doi: 10.1016/j.archger.2019.01.003
pii:
doi:

Types de publication

Journal Article Randomized Controlled Trial

Langues

eng

Sous-ensembles de citation

IM

Pagination

245-251

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2019 Elsevier B.V. All rights reserved.

Auteurs

Manuela Hödl (M)

Medical University of Graz, Institute of Nursing Science, Universitätsplatz 4/3, 8010 Graz, Austria. Electronic address: manuela.hoedl@medunigraz.at.

Ruud J G Halfens (RJG)

Maastricht University, Department of Health Services Research, CAPHRI, Care and Public Health Research Institute, Duboisdomein 30, 6229 GT Maastricht, the Netherlands. Electronic address: r.halfens@maastrichtuniversity.nl.

Christa Lohrmann (C)

Medical University of Graz, Institute of Nursing Science, Universitätsplatz 4/3, 8010 Graz, Austria. Electronic address: christa.lohrmann@medunigraz.at.

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Classifications MeSH