A Staff Management System for Maintaining Improvements in Continence With Elderly Nursing Home Residents

Abstract

We developed a staff management system for maintaining treatment gains achieved on a specialized continence unit located in a geriatric nursing home. Geriatric assistants learned to use a prompted voiding procedure to maintain improved dryness for 4 elderly residents. The staff management system induded self-monitoring and recording of prompted voiding activities and supervisory monitoring and feedback based on group performance of these activities. Results show that the system was effective in maintaining prompted voiding activities with corresponding maintenance of improved patient continence. However, a gradual decline in staff performance was noted 4 to 5 months after the initiation of the system. During a subsequent phase of the study, provision of individual feedback restored staff performance to previous levels. Results are discussed in relation to the practicality of prompted voiding interventions in nursing home environments and the applicability of staff management systems in this setting.DESCRIPTORS: institutional staffmanagement, incontinence, behavioral gerontology, prompted voiding Behavioral interventions have been used successfully to treat various problems of institutionalized elderly individuals (Williamson & Ascione, 1983). However, much of the research focusing on the care ofsuch persons has involved specially trained research personnel as behavior change agents. Because these individuals are often not responsible for routinely carrying out treatment procedures in nursing homes, the applied significance of this research is in doubt.

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