Incontinence management
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Modules - Incontinence Management
CONTINUOUS QUALITY ASSESSMENTS HELP ENSURE PROGRAM SUCCESS
By the time you get this far in implementing a prompted voiding program, you'll feel the major work is behind you, so you'll be sorely tempted to skip this last step. Our advice? Resist the temptation. Here's why: Having accomplished Steps 1 (Conduct a basic assessment), 2 (Prompted voiding trial), and 3 (Program implementation), your facility now has a significant investment in improving the quality of incontinence care for residents. All that time and money will go to waste, however, unless supervisors conduct regular "wet" checks to make sure nurse aides continue to provide quality care. Most nursing homes forego this step only to pay a price for their negligence: studies show that in the absence of quality control assessment, nurse aides backslide and fail to consistently implement prompted voiding with incontinent residents (1).
Evidently, old habits are hard to break and new ones are hard to maintain if you don't get timely feedback about how you're doing, including reinforcement for doing things right and recommendations for improvement if you're doing things wrong. This feedback loop is a hallmark of continuous quality improvement programs. Commenting on the proven effectiveness of these programs, geriatrician John Morley and his colleagues observe (2): "It does not take the wizardry of Harry Potter to curb errors, but rather the 'magic' of data collection, analysis, and self-correction in a timely way (2003; pg. 809)." Step 4 is all about this kind of magic.
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