Topic:Mapping evidence about continence care in aged care to the Aged Care Quality Standards

Day: Wednesday 14 October

Time:  3:30pm-4:00pm AEDT

Abstract:

Background: Incontinence is a significant health care problem that disproportionately affects people living in residential aged care homes. Best practice recommendations call for a comprehensive assessment to identify and address potentially modifiable causes of incontinence, and for initial behavioural interventions to optimise residents’ continence. Evidence presented to the Australian Royal Commission into Aged Care Quality and Safety raises serious questions about the quality of continence care some residents receive. Background: Incontinence is a significant health care problem that disproportionately affects people living in residential aged care homes. Best practice recommendations call for a comprehensive assessment to identify and address potentially modifiable causes of incontinence, and for initial behavioural interventions to optimise residents’ continence. Evidence presented to the Australian Royal Commission into Aged Care Quality and Safety raises serious questions about the quality of continence care some residents receive. 
Objective: To identify, appraise and summarise current evidence about incontinence and other bladder and bowel symptoms in residential aged care facilities and map the findings to the Aged Care Quality Standards.
Methods: Joanna Brigg’s Institute scoping review methodology was used to identify and appraise empirical research about continence care, i.e. the assessment and management of incontinence and other bladder and bowel symptoms in the context of residential aged care was eligible for inclusion. Studies were sorted by topic. Two reviewers extracted data about the study aim, setting, methods and findings and constructed a summary statement for each study. Using the cross comparative technique, two researchers independently engaged in a process of categorising and recategorising the summary statements and reframing them as recommendations. Thereafter they independently sifted through each statement/recommendation and selected those that were most relevant to each Aged Care Quality Standard. 
Result: The study resulted in several outcomes, including evidence about the prevalence of, and risk factors for incontinence and other bladder and bowel symptoms in residential aged care, the impact these symptoms, current continence care, and factors that influence the quality of continence care in residential aged care homes. Attributes of high continence care in residential aged care were identified, and a series of evidence-based recommendations were constructed about:(i) Caring for residents with incontinence and other bladder and bowel symptoms (ii) Caring for residents with an indwelling urinary catheter(iii) Caring for residents with incontinence-associated dermatitis(iv) Education for the residential aged care workforce (v) Organisational and policy factors that influence the quality of continence care(vi) End of life continence care. 
The project also resulted in a framework with the review recommendations mapped to the Aged Care Quality Standards. The map offers a framework of key factors to consider when meeting aged care residents’ continence care needs and could assist organisations to implement and maintain compliance with the Quality Standards. 
Funding: The project was funded by The Continence Foundation of Australia.   

 

 

 

Biography:

Dr Ostaszkiewicz is an established leader in the nursing care of frail older people with continence care needs. Her research program spans three core areas: (i) Improving the quality of fundamental care for older people with continence care needs, (ii) Building the capacity of the aged care and continence care workforce to deliver evidence-based continence care and (iii) The development and evaluation of evidence-based knowledge translation resources about continence care. Her research has established the prevalence of incontinence in Australian subacute and acute care settings, identified gaps in evidence about continence management for frail older adults, revealed ethical challenges associated with providing continence care, and described the inadvertent negative effects of regulation on the quality of continence care in residential aged care homes.

Professor Briony Dow is Director of the National Ageing Research Institute and Honorary Professor at the School of Population and Global Health, University of Melbourne and Honorary Professor, School of Nursing and Midwifery, Deakin University. At NARI Briony oversees a range of both aged care and social and clinical gerontology research programs, including her own research into elder abuse and carer mental health.

Dr Jessica Cecil is an early career researcher at the National Ageing Research Institute. She has specific expertise in literature review, coding and thematic analysis, focus group facilitation and survey development. Jess is currently managing the project to design and evaluate a best practice model for continence care in residential aged care facilities.

Ms Leona Kosowicz is a Research Fellow at the National Ageing Research Institute. She has considerable experience in reviewing evidence, coding and thematic analysis. She is currently working on the project to design and evaluate a best practice model of continence care for residential aged care homes.