Accepted for/Published in: JMIR Research Protocols
Date Submitted: Aug 10, 2020
Date Accepted: Dec 7, 2020
Improving assessment, diagnosis, and management of urinary incontinence and lower urinary tract symptoms on acute and rehabilitation wards that admit adult patients post-stroke: A protocol for a before-and-after implementation study.
ABSTRACT
Background:
Urinary incontinence (UI) and lower urinary tract symptoms (LUTS) are commonly experienced by adult inpatients. While peak bodies recommend health services have systems for optimal UI and LUTS practice, it is often not delivered. In the 2017 Australian National Acute Stroke Audit, of the third inpatients with UI, only 18% received a management plan. There is little reporting of effective inpatient interventions to systematically deliver optimal UI/LUTS care.
Objective:
This protocol outlines the study in which we aim to determine if our UI/ LUTS practice-change package is feasible and effective for delivering optimal UI/LUTS care. Our package includes an intervention (SCAMP) synthesized from the best-available evidence, implemented used theoretically-informed implementation strategies targeting identified barriers and enablers. It targets clinicians working on the participating wards. We will determine the change in the proportion of inpatients receiving optimal UI/LUTS care, including assessment, diagnosis and management plans. Potential economic implications (cost and consequences) for hospitals implementing SCAMP will be determined.
Methods:
This is a pragmatic, real-world, before- and after- implementation study conducted at 12 hospitals (15 wards: 7 metropolitan, 8 regional) in Australia. Data will be collected at three time points: before-implementation (T0), immediately after the 6-month implementation period (T1) and again after a 6-month maintenance period (T2). Changes in optimal clinical practice will be determined via medical record audits.
Results:
This study has been approved by the Hunter New England Human Research Ethics Committee (HNEHREC Reference No: 18/10/17/4.02). Pre-implementation data collection will be completed by 31 Aug 2020.
Conclusions:
Our practice-change package is designed to reduce the current evidence-practice gap in optimal inpatient UI/ LUTS practice. This study has been designed to provide clinicians, managers and policy makers with the evidence needed to assess the potential benefit of further, wide scale implementation of our practice-change package. Clinical Trial: Nil
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