Intervention for Alleviating Clinical Inertia in the Management of Urinary Incontinence.

ABSTRACT

PURPOSE: The purpose of this study was to determine whether clinical inertia exists in the care of patients with urinary incontinence and to test the effects of an educational intervention designed to alleviate inertia related to care of urinary incontinence. DESIGN: Single-group, pretest/posttest design. SUBJECTS AND SETTING: The sample comprised 132 participants practicing in 6 medical-surgical inpatient care units at an urban hospital in Almería, Spain; 66 (50%) were RNs, and all other participants were unlicensed assistive personnel. Most participants (87.9%) were female; their average age was 43.99 years (SD = 7.85 years). METHODS: An educational intervention (online course) was provided. The main objective of the course was application of evidence-based knowledge for prevention and management of urinary incontinence in hospitalized patients. The course program comprised 3 didactic units (1) introduction and evaluation of the patient with urinary incontinence, (2) care plans, and (3) instructions and rational use of absorbent products. Data collection included demographic and professional characteristics of respondents, desired results when caring for patients with incontinence, a medical record checklist, an occupational environment and satisfaction scale, and an assessment record of knowledge/skills and training activity satisfaction. RESULTS: After comparing the pre- and posttest scores of knowledge on urinary incontinence, significant differences were found before and after the intervention (z = -14.113, P = .000). Specifically, analysis revealed differences in caring actions related to urinary incontinence (z = -14.248, P = .000) and differences in direct observation of urinary incontinence practice following the intervention (z = -14.326, P = .000). CONCLUSIONS: Our findings indicate existence of inertia in nursing care for hospitalized patients with urinary incontinence. The educational intervention improved knowledge, observable nursing care activities related to incontinence management, and improved documentation of care.