Objectives: The objectives of this implementation project were to review the nursing assessment and management of adult patients with urinary and fecal incontinence, and to develop local guidelines and ward-based continence assessment tools to assist nursing staff in assessing and managing incontinence. Introduction: Urinary or fecal incontinence in acute care hospitals is a growing issue that can lead to constipation, depression, breakdown of skin integrity, increased nursing home placement of older patients, increased length of hospital stay, and escalated healthcare costs. In many cases, incontinence can be treated and managed effectively; however, it is poorly understood and under-prioritized in many hospital settings. Methods: A pre–post intervention chart audit was conducted to review compliance with 10 best-practice criteria for incontinence assessment and management. Following baseline data analysis, barriers to compliance with the criteria were identified and subsequently addressed using targeted strategies. The project utilized the JBI Practical Application of Clinical Evidence System (PACES) and the Getting Research into Practice (GRiP) tools. Results: Education on continence strategies was delivered to nursing staff, which resulted in improved compliance for all audit criteria. There were notable improvements in the nursing documentation, and assessment and management of patients with urinary and/or fecal incontinence in the post-intervention analysis. Conclusions: The results demonstrate that nursing education and formalized assessment pathways in an acute setting can improve nursing compliance with the assessment and management of patients with either urinary or fecal incontinence to ensure safe, compassionate and person-centered care.

The baseline audit revealed gaps between current practice and best practice. Through the implementation of a targeted education program and resource package, outcomes improved in the follow up audit. The findings indicated that engagement from multidisciplinary team members and consumers was effective in developing tailored education that improved knowledge of best practice. This was demonstrated by an increase in the percentage of compliance across the 10 criteria, although leaving room for more improvement. A policy has been developed for implementation and future audits are planned to measure whether improved practices have been sustained.

The objectives of this project were to conduct a retrospective healthcare records audit to determine the current compliance with evidence-based criteria regarding perioperative management of patients with diabetes; to identify barriers and facilitators to achieve compliance and develop strategies to address areas of non-compliance, and to implement evidence-based best practice recommendations for perioperative diabetic management and to assess the effectiveness of these strategies in improving compliance of perioperative diabetic management across five participating clinical areas in a large tertiary referral hospital.Introduction: Type 2 diabetes is a frequent co-morbidity among inpatients. It affects up to 20% of the general surgical population. Patients with diabetes undergoing surgery have a greater complication rate and length of hospital stay. Optimization of diabetes management of hospitalized patients will improve quality of care delivery, prevent postoperative complications and reduce length of stay and costs. However, there is limited knowledge and understanding of whether the current nursing practices concerning perioperative diabetic management meet the best practice recommendations outlined by JBI best practice criteria.Methods: A pre-post intervention healthcare record audit was conducted to examine compliance with nine best practice recommendations for perioperative diabetic management across five clinical areas. Following preintervention data analysis along with two focus group discussions, barriers to compliance with best practice criteria were identified and targeted strategies were used to address the issues. This project used the JBI Practice Application of Clinical Evidence System (PACES) and Getting Research into Practice (GRiP) tools.Results: Face to face education sessions and educational resources relating to perioperative diabetic management were delivered to nursing staff, which resulted in improved compliance for most of the audit criteria, with significant improvement in the areas of regular blood glucose level monitoring and nursing staff receiving education and training in the post-implementation analysis.