To what extent are national guidelines for the management of urinary incontinence in women adhered? Data from a national audit

Abstract

Objective To assess the degree of adherence to the current National Institute for Health and Clinical Excellence (NICE) guidelines on the management of urinary incontinence (UI) in women.Design Retrospective survey of consecutive female inpatients and outpatients with UI as part of a national audit.Setting NHS hospital and primary care (PC) trusts.Population or sample Twenty-five women <65 years old and 25 women ‡65 years old from each participating site.Method All NHS trusts in England, Wales and Northern Ireland were eligible to participate. A web-based data collection form aligned to the NICE guidelines was constructed for the study. All data submitted to the audit were anonymous and access to the web-tool was password-protected for confidentiality. Conclusion Older women are less likely to receive NICE compliant management. Adherence varies according to recommendation. There needs to be concentration on evidence-based community provision of care by competent and interested clinicians before the aims of the NICE guidelines are met.

Urinary incontinence in frail elderly persons: Report from the 5th International Consultation on Incontinence

“…The US government sets minimum quality standards for UI assessment and management in long‐term care, but these standards, along with basic fundamental principles of UI, are poorly understood by long‐term staff . Two groups, the US Assessing Care of Vulnerable Elders (ACOVE) project and the UK Clinical Effectiveness and Evaluation Unit, have developed quality performance measures for UI care in frail older people, using structured literature and expert panel review . It should be borne in mind that multiple diagnoses can co‐exist, and due consideration given to mixed UI, combining urge and stress elements, and detrusor hyperactivity with impaired contractility (DHIC) …”

A national benchmark for the initial assessment of men with LUTS: data from the 2010 Royal College of Physicians National Audit of Continence Care

“…The study was applicable to all people with lower urinary tract symptoms (voiding and storage disorders), bladder and bowel dysfunction, urinary incontinence and faecal incontinence. Results from the audit of faecal incontinence [10] and those for urinary incontinence in women [11] have been reported elsewhere. Patients were suitable if aged 18 or over; sufficient time had elapsed to allow assessment and formulation of a management plan; a catheter was inserted for urinary incontinence rather than retention; and incontinence was either an old or a new complaint.…”

The Increasing Importance of A Continence Nurse Specialist To Improve Outcomes And Save Costs of Urinary Incontinence Care: An Analysis of Future Policy Scenarios

“…Even in extreme case scenarios our results appeared to be rather robust and the implementation of the OCSS new care strategy remained cost-saving compared to usual care. Several studies [12][13][14] indicated areas for improvement in the management and treatment of urinary incontinence. Our results show that improvement of care pathways by implementing a continence nurse specialist not only results in better clinical outcomes but also contributes to important cost-savings.…”

“…Several studies [12][13][14] have indicated areas for improvement in the management and treatment of urinary incontinence, especially in elderly living in the community. The Optimum Continence Service Specification (OCSS) was developed in order to improve urinary incontinence care in different healthcare settings for four different incontinence patient profiles: i) stress and urgency urinary incontinence, ii) faecal incontinence, iii) neurological induced incontinence, and iv) urinary incontinence in the elderly/ cognitively impaired [15].…”