An action research study to improve resident-centred continence care in a multi-purpose service

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Background: This study aimed to improve continence assessment, treatment and management in the residential aged care section of a Multi-Purpose Service (MPS) in rural Australia. Given the 70.9% prevalence rates of incontinence occurring in Australian aged care residents, nurses and care staff consider incontinence to be inevitable in older age and fail to consider its significance for the resident. The use of containment devices and regular toileting rounds are therefore, commonplace, and increases resident dependency and cost of care. Method: Action research was used with nurses and care staff to address continence care practices for older people living in the aged care section of one multi-purpose service (MPS) in rural New South Wales. Following a staff survey to identify the staff’s baseline continence attitudes, knowledge and management for older people, the manager and senior staff of the MPS chose to improve continence care practices for their aged care residents. The data generated by the action group over the two year action research study included meeting minutes, memos, staff surveys, staff and manager interviews, resident continence care plans and researcher field notes. Results: Nurses and care staff became more aware and proactive in developing, implementing and evaluating individualised continence care for their residents. Staff were highly satisfied with helping residents to regain and/or maintain continence. They enthusiastically engaged with further learning on best-practice continence care and supporting each other in maintaining this level of care. Discussion: Action research enables nurses and care staff to collaborate in practice change, so long as they have the committed support and the encouragement of their managers and sufficient time for the change process. Helping aged care residents to regain, or maintain, continence is achievable when these staff are willing to collaborate to achieve this goal. Individualising continence care for aged care residents can assist with improving their quality of life. Conclusion: When nurses, care staff and care managers collaborate through action research they are able to produce quality care practices and positive outcomes for older people. In this study the benefits achieved through action research were individualised continence care regimens for aged care residents living in a MPS, and improved resident continence and quality of life, confirming previous research. Health and aged care services can also benefit by instituting targeted education, policies and practice guidelines which teach nurses and care staff how to individualise continence care for older people. Nursing and care staff educators need to encourage continence care improvement for older people through their promotion of non-ageist assumptions of continence ability in older age.
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