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Incontinence: prevalence, management, staff knowledge and professional practice environment in rehabilitation units
Author(s) -
McCarthy Geraldine,
McCormack Brendan,
Coffey Alice,
Wright Jayne,
Slater Paul
Publication year - 2009
Publication title -
international journal of older people nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.707
H-Index - 29
eISSN - 1748-3743
pISSN - 1748-3735
DOI - 10.1111/j.1748-3743.2008.00155.x
Subject(s) - medicine , nursing , urinary incontinence , context (archaeology) , audit , autonomy , rehabilitation , health care , fecal incontinence , physical therapy , urology , paleontology , management , economic growth , political science , gastroenterology , law , economics , biology
Background. Bladder and bowel incontinence is a major health care problem, which adversely affects the lives of many individuals living at home or in health service facilities. Current approaches to continence care emphasize comfort, safety and reduction of risk, rather than detailed individualized assessment and management. The literature illustrates a gap between evidence and actual practice and emphasizes the context of care as being a key element for successful implementation of evidence based practice. Aims. To identify prevalence of bowel and bladder incontinence and its management, investigate continence knowledge and describe the professional practice environment within a rehabilitation unit for older people. Method. An integrated evaluation of continence prevalence, staff knowledge and the work environment was adopted. Results. Findings revealed a high incidence of incontinence (60% urinary, 3% faecal, 37% mixed) a lack of specific continence assessment and specific rationale for treatment decisions or continuation of care. The focus was on continence containment rather than on proactive management. Staff demonstrated a reasonable knowledge of incontinence causation and treatment as measured by the staff knowledge audit. The evaluation of the work environment indicated a low to moderate perception of control over practice (2.39), autonomy in practice (2.87), nurse doctor relationship (2.67) and organizational support (2.67).