Age and Ageing Advance Access published online on November 21, 2007
Age and Ageing, doi:10.1093/ageing/afm163
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National audit of continence care for older people: management of urinary incontinence
1 Geriatric Medicine, University College Hospital, 25 Grafton Way, London WC1E 6AU, UK
2 Clinical Effectiveness and Evaluation Unit, Royal College of Physicians of London, London NW1 4LE, UK
Address correspondence to: Adrian Wagg. Tel: 0207 380 9910; Fax: 0207 380 9652. Email: a.wagg{at}ucl.ac.uk
Introduction: the Department of Health report ‘Good practice in continence services’ highlights the need for proper assessment and management of urinary incontinence. The National Service Framework for Older People required service providers to establish integrated continence services by April 2004. A national audit was conducted to assess the quality of continence care for older people and whether these requirements have been met.
Method: the audit studied incontinent individuals of 65 years and over. Each site returned data on organisational structure and the process of 20 patients’ care. Data were submitted via the internet, and all were anonymous.
Results: the national audit was conducted across England, Wales and Northern Ireland. Data on the care of patients/residents with bladder problems were returned by 141/326 (43%) of primary care trusts (PCT), by 159/196 (81%) of secondary care trusts (involving 198 hospitals) and by 29/309 (9%) of invited care homes. In all 58% of PCT, 48% of hospitals and 74% of care homes reported that integrated continence services existed in their area. Whilst basic provision of care appeared to be in place, the audit identified deficiencies in the organisation of services, and in the assessment and management of urinary incontinence in the elderly.
Conclusion: the results of this audit indicate that the requirement for integrated continence services has not yet been met. Assessment and care by professionals directly looking after the older person were often lacking. There is an urgent need to re-establish the fundamentals of continence care into the practice of medical and nursing staff and action needs to be taken with regard to the establishment of truly integrated, quality services in this neglected area of practice.
Keywords: urinary incontinence, older people, audit, clinical effectiveness, elderly
Received 19 November 2006; accepted in revised form 19 June 2007.
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