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Urinary incontinence and its management in patients aged 65 and older in orthopaedic care - what nursing and rehabilitation staff know and do

Hälleberg Nyman, Maria; Forsman, Henrietta; Ostaszkiewicz, Joan; Hommel, Ami LU and Eldh, Ann Catrine (2017) In Journal of Clinical Nursing 26(21-22). p.3345-3353
Abstract

Aims and objectives: To describe what nursing and rehabilitation staff know and do with regard to urinary incontinence and risk of urinary incontinence in patients 65 years or older undergoing hip surgery. Background: Urinary incontinence is a common but often neglected issue for older people. Despite the existence of evidence-based guidelines on how to assess, manage and prevent urinary incontinence, there are indications that these guidelines are not applied in hospital care. Design: A qualitative study with descriptive design was conducted in two orthopaedic units. Methods: Forty-six interviews and 36 observations of care were conducted from January-October 2014 and analysed with qualitative content analysis. Results: Enrolled nurses... (More)

Aims and objectives: To describe what nursing and rehabilitation staff know and do with regard to urinary incontinence and risk of urinary incontinence in patients 65 years or older undergoing hip surgery. Background: Urinary incontinence is a common but often neglected issue for older people. Despite the existence of evidence-based guidelines on how to assess, manage and prevent urinary incontinence, there are indications that these guidelines are not applied in hospital care. Design: A qualitative study with descriptive design was conducted in two orthopaedic units. Methods: Forty-six interviews and 36 observations of care were conducted from January-October 2014 and analysed with qualitative content analysis. Results: Enrolled nurses performed most of the care related to bladder function, with focus on urinary catheterisation and preventing urinary tract infection and urinary retention. Registered nurses' role in urinary matters mainly comprised documentation, while the rehabilitation staff focused on making it possible for the patient to be independent in toileting. The nursing staff considered urinary incontinence a common condition for older people and that it was convenient for the patients to have an indwelling catheter or incontinence pad/pant, although they acknowledged some of the risks associated with these procedures. Conclusions: Urinary incontinence is not a priority in orthopaedic care, and urinary incontinence guidelines are not applied. Further, attitudes and actions are mainly characterised by a lack of urinary incontinence knowledge and the nursing and rehabilitation staff do not take a team approach to preventing and managing urinary incontinence. Relevance to clinical practice: An increased focus on knowledge on urinary incontinence and evidence-based guidelines is needed. To secure evidence-based practice, the team of nursing and rehabilitation staff and managers must be aligned and work actively together, also including the patient in the team.

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author
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Evidence-based practice, Hip surgery, Knowledge implementation, Older people, Orthopaedic care, Urinary incontinence
in
Journal of Clinical Nursing
volume
26
issue
21-22
pages
3345 - 3353
publisher
Wiley-Blackwell
external identifiers
  • scopus:85012260286
ISSN
0962-1067
DOI
10.1111/jocn.13686
language
English
LU publication?
no
id
08da1599-9308-4ba2-b1fb-d393c3159e52
date added to LUP
2017-02-23 11:10:41
date last changed
2018-01-07 11:52:18
@article{08da1599-9308-4ba2-b1fb-d393c3159e52,
  abstract     = {<p>Aims and objectives: To describe what nursing and rehabilitation staff know and do with regard to urinary incontinence and risk of urinary incontinence in patients 65 years or older undergoing hip surgery. Background: Urinary incontinence is a common but often neglected issue for older people. Despite the existence of evidence-based guidelines on how to assess, manage and prevent urinary incontinence, there are indications that these guidelines are not applied in hospital care. Design: A qualitative study with descriptive design was conducted in two orthopaedic units. Methods: Forty-six interviews and 36 observations of care were conducted from January-October 2014 and analysed with qualitative content analysis. Results: Enrolled nurses performed most of the care related to bladder function, with focus on urinary catheterisation and preventing urinary tract infection and urinary retention. Registered nurses' role in urinary matters mainly comprised documentation, while the rehabilitation staff focused on making it possible for the patient to be independent in toileting. The nursing staff considered urinary incontinence a common condition for older people and that it was convenient for the patients to have an indwelling catheter or incontinence pad/pant, although they acknowledged some of the risks associated with these procedures. Conclusions: Urinary incontinence is not a priority in orthopaedic care, and urinary incontinence guidelines are not applied. Further, attitudes and actions are mainly characterised by a lack of urinary incontinence knowledge and the nursing and rehabilitation staff do not take a team approach to preventing and managing urinary incontinence. Relevance to clinical practice: An increased focus on knowledge on urinary incontinence and evidence-based guidelines is needed. To secure evidence-based practice, the team of nursing and rehabilitation staff and managers must be aligned and work actively together, also including the patient in the team.</p>},
  author       = {Hälleberg Nyman, Maria and Forsman, Henrietta and Ostaszkiewicz, Joan and Hommel, Ami and Eldh, Ann Catrine},
  issn         = {0962-1067},
  keyword      = {Evidence-based practice,Hip surgery,Knowledge implementation,Older people,Orthopaedic care,Urinary incontinence},
  language     = {eng},
  month        = {02},
  number       = {21-22},
  pages        = {3345--3353},
  publisher    = {Wiley-Blackwell},
  series       = {Journal of Clinical Nursing},
  title        = {Urinary incontinence and its management in patients aged 65 and older in orthopaedic care - what nursing and rehabilitation staff know and do},
  url          = {http://dx.doi.org/10.1111/jocn.13686},
  volume       = {26},
  year         = {2017},
}