Bishop Benziger College of Nursing, Quilon, Kerala, India.
Pushpagiri Centre for Evidence-Based Practice: A JBI Centre of Excellence, Thiruvalla Kerala, India.
JBI Evid Implement. 2024 Aug 1;22(3):242-249. doi: 10.1097/XEB.0000000000000432.
This project aimed to implement best practices for pelvic floor muscle training to manage urinary incontinence among older women in long-term care in Kerala, India.
Urinary incontinence is a prevalent and distressing condition that affects a significant proportion of older adults and is characterized by involuntary loss of urine, leading to social embarrassment, decreased quality of life, and increased health care costs. It is more prevalent in women and is associated with dementia, limited mobility, and other comorbidities in long-term care. Pelvic floor muscle training is a first-line treatment option for urinary incontinence in older adults, given its potential to improve quality of life and reduce health care costs.
This project was based on the JBI Evidence Implementation Framework. A baseline audit was conducted to evaluate current practice against best practices. After identifying barriers and implementing strategies, follow-up audits were conducted after 3 and 6 months.
The baseline audit showed 0% compliance with all best practices. Barriers such as lack of knowledge and practice of pelvic floor exercises for urinary incontinence among participants and nurses; unknown cognitive status; and health emergencies were identified. Strategies including video-assisted training of pelvic floor muscle exercises, training calendars, and flip charts with instructions. The follow-up audits showed significant improvements in compliance.
This project reduced urinary incontinence in the participants. Although two of the audit criteria did not reach 100% compliance by the end of 6 months, the stakeholders of the long-term care facility understood the importance of pelvic floor muscle training, which will be beneficial for future residents with urinary incontinence.
本项目旨在印度喀拉拉邦的长期护理机构中实施最佳的盆底肌训练实践,以管理老年女性的尿失禁问题。
尿失禁是一种普遍且令人痛苦的疾病,影响着相当一部分老年人,其特征是尿液不受控制地流失,导致社交尴尬、生活质量下降和医疗保健费用增加。女性中更为常见,与痴呆症、行动受限和长期护理中的其他合并症有关。对于老年患者的尿失禁,盆底肌训练是一线治疗选择,因为它有可能改善生活质量并降低医疗保健成本。
本项目基于 JBI 证据实施框架。进行基线审核以评估当前实践与最佳实践的符合情况。在确定障碍并实施策略后,在 3 个月和 6 个月后进行后续审核。
基线审核显示,所有最佳实践的合规性均为 0%。确定了一些障碍,如参与者和护士对尿失禁的盆底肌锻炼缺乏知识和实践;认知状态未知;以及医疗紧急情况。实施的策略包括视频辅助的盆底肌锻炼培训、培训日历和带有说明的翻转图表。后续审核显示合规性有显著提高。
本项目减少了参与者的尿失禁。尽管有两个审核标准在 6 个月结束时未达到 100%的合规性,但长期护理机构的利益相关者理解了盆底肌训练的重要性,这将对未来有尿失禁问题的居民有益。