Incontinence management
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Modules - Incontinence Management
Translating Clinical Research into Practice: A Randomized Controlled Trial of Exercise and Incontinence Care with Nursing Home Residents.
John F. Schnelle, Cathy A. Alessi, Sandra F. Simmons, Nahla R. Al-Samarrai, John C. Beck, Joseph G. Ouslander, 2002, in Journal of the American Geriatrics Society, 50:1476-1483.
An incontinence care and exercise intervention called FIT, for Functional Incidental Training, resulted in significant improvements in physical mobility and continence for most residents who received the intervention. The staffing requirements needed to implement the intervention, however, are high and exceed the resources available in most nursing homes.
In this randomized, controlled trial, research staff prompted each of 94 intervention residents to toilet every two hours, five days a week, between 8 am and 4:30 pm. Before or after providing incontinence care, staff encouraged the residents to walk or, if nonambulatory, to wheel their chairs and to repeat sit-to-stands up to eight times. Once a day, each resident was given upper body resistance training. Before and after each care episode, staff offered fluids to residents. After 32 weeks of FIT, intervention residents maintained or improved performance on 14 of 15 outcome measures, whereas the performance of the 96 residents in the control group declined.
The mean time required to implement the intervention each time care was provided was 20.7 minutes. Consequently, one nurse aide for every five residents would be needed to implement the intervention. Less than 10% of the nation's nursing homes are staffed at this level. The researchers conclude, "Fundamental changes in the staffing of most nursing homes will be necessary to translate efficacious clinical interventions into everyday practice."
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