Abstract
BackgroundBladder and bowel control difficulties affect 20% and 10% of the UK population, respectively, touch all age groups and are particularly prevalent in the older (65+ years) population. However, the quality of continence care is often poor, compromising patient health and well-being, increasing the risk of infection, and is a predisposing factor to nursing and residential home placement.ObjectiveTo identify factors that help or hinder good continence care for patients aged 65 years and over in hospital medical ward settings. Medical care, not surgical, was our exclusive focus.MethodsWe conducted 27 qualitative interviews with nursing, medical and allied health practitioners in three hospitals. We used a purposive sample and analysed data thematically, both manually and with the aid of NVivo software.ResultsInterviews revealed perspectives on practice promoting or inhibiting good quality continence care, as well as suggestions for improvements. Good continence care was said to be advanced through person-centred care, robust assessment and monitoring, and a proactive approach to encouraging patient independence. Barriers to quality care centred on lack of oversight, automatic use of incontinence products and staffing pressures. Suggested improvements centred on participatory care, open communication and care planning with a higher bladder and bowel health profile. In order to drive such improvements, hospital-based practitioners indicate a need and desire for regular continence care training.ConclusionsFindings help explain the persistence of barriers to providing good quality care for patients aged 65 years and over with incontinence. Resolute continence promotion, in hospitals and throughout the National Health Service, would reduce reliance on products and the accompanying risks of patient dependency and catheter-associated gram-negative bacteraemia. Robust assessment and care planning, open communication and regular continence care training would assist such promotion and also help mitigate resource limitations by developing safer, time-efficient continence care.
Funder
University Hospitals Bristol and Weston NHS Foundation Trust, Research Capability Funding (RCF) stream
Subject
Public Health, Environmental and Occupational Health,Health Policy,Leadership and Management
Reference37 articles.
1. NHS England . Excellence in continence care: practical guidance for commissioners, and leaders in health and social care. NHS, 2018. Available: https://www.england.nhs.uk/wp-content/uploads/2018/07/excellence-in-continence-care.pdf [Accessed 13 Jan 2021].
2. James Lind Alliance . Incontinence: the taboo hurting the dignity and health of millions. James Lind alliance, 2018. Available: http://www.jla.nihr.ac.uk/news/incontinence-the-taboo-hurting-the-dignityand-health-of-millions/9151 [Accessed 13 Jan 2021].
3. Prevalence of urinary and faecal incontinence and nocturnal enuresis and attitudes to treatment and help-seeking amongst a community-based representative sample of adults in the United Kingdom
4. Older people, continence care and catheters: dilemmas and resolutions;Godfrey;Br J Nurs,2008
5. Holroyd S . What can we do to improve the patient experience of continence care? J Comm Nurse 2015 https://www.jcn.co.uk/files/downloads/articles/jcn-04-2015-15-what-can-we-do-to-improve-patient-experience-continence.pdf
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