The design and feasibility pilot of a model to guide continence care in Australian residential aged care homes

Abstract

To co-design and pilot test a best practice model of continence care and knowledge translation resources for Australian residential aged care, a mixed methods study was undertaken. The study had four stages: (1) a scoping review of literature; (2) a survey, interviews and co-design workshops with residential aged care stakeholders; (3) the co-design of a draft model and knowledge translation resources; and (4) a pilot trial of an education program and qualitative interviews with residents. The pilot trial involved a convenience sample of 22 staff (registered and enrolled nurses and personal care assistants) from two Australian residential aged care homes. Staff completed one pre- and two post-education surveys, and 13 aged care residents were interviewed about their views about continence care. Pilot test data revealed post-education improvements in staff knowledge for eight of the ten questions, and 100% agreement on the feasibility, appropriateness and acceptability of the model and education program. Of the 22 participants, 63% rated the education as ‘very helpful’ in applying the model to practice and 37% rated it as ‘somewhat helpful’. There was no statistically significant difference between the results of any of the three assessment surveys. A content analysis of resident interviews validated the importance of evidence-based, safe, clinically-informed, person-centred continence care that optimises a resident's functional abilities and responds to their individual needs, choices and dignity. The Continence Foundation of Australia has used these findings to design Continence SMART Care (CSC), which represents best practice continence care, meets the Aged Care Quality Standards, and aligns with current reform strategies for the aged care sector. Further research is required to determine the impact on practice and resident outcomes, and its relevance for use in other settings or countries.