OBJECTIVES: To examine clinical outcomes and describe the staffing requirements of an incontinence and exercise intervention. DESIGN: Randomized controlled trial with blinded assessments of outcomes at three points over 8 months. SETTING: Four nursing homes. PARTICIPANTS: Two hundred fifty-six incontinent residents. INTERVENTION: Research staff provided the intervention, which integrated incontinence care and exercise every 2 hours from 8:00 a.m. to 4:00 p.m. 5 days a week. MEASUREMENTS: Average and maximum distance walked or wheeled, level of assistance required to stand, maximum pounds lifted by arms, fecal and urinary incontinence frequency, and time required to implement intervention. RESULTS: Intervention residents maintained or improved performance whereas the control group's performance declined on 14 of 15 outcome measures. Repeated measures analysis of variance group-by-time significance levels ranged from P <.0001 to.05. The mean time required to implement the intervention each time care was provided was 20.7 +/- 7.2 minutes. We estimate that a work assignment of approximately five residents to one aide would be necessary to provide this intervention. CONCLUSIONS: The incontinence care and exercise intervention resulted in significant improvement for most residents, and most who could be reliably interviewed expressed a preference for such care. Fundamental changes in the staffing of most nursing homes will be necessary to translate efficacious clinical interventions into everyday practice.
RCT Entities:
OBJECTIVES: To examine clinical outcomes and describe the staffing requirements of an incontinence and exercise intervention. DESIGN: Randomized controlled trial with blinded assessments of outcomes at three points over 8 months. SETTING: Four nursing homes. PARTICIPANTS: Two hundred fifty-six incontinent residents. INTERVENTION: Research staff provided the intervention, which integrated incontinence care and exercise every 2 hours from 8:00 a.m. to 4:00 p.m. 5 days a week. MEASUREMENTS: Average and maximum distance walked or wheeled, level of assistance required to stand, maximum pounds lifted by arms, fecal and urinary incontinence frequency, and time required to implement intervention. RESULTS: Intervention residents maintained or improved performance whereas the control group's performance declined on 14 of 15 outcome measures. Repeated measures analysis of variance group-by-time significance levels ranged from P <.0001 to.05. The mean time required to implement the intervention each time care was provided was 20.7 +/- 7.2 minutes. We estimate that a work assignment of approximately five residents to one aide would be necessary to provide this intervention. CONCLUSIONS: The incontinence care and exercise intervention resulted in significant improvement for most residents, and most who could be reliably interviewed expressed a preference for such care. Fundamental changes in the staffing of most nursing homes will be necessary to translate efficacious clinical interventions into everyday practice.
Authors: Sandra F Simmons; Daniel W Durkin; Matthew S Shotwell; Scott Erwin; John F Schnelle Journal: Transl Behav Med Date: 2013-06 Impact factor: 3.046
Authors: Marilyn J Rantz; Mary Zwygart-Stauffacher; Lanis Hicks; David Mehr; Marcia Flesner; Gregory F Petroski; Richard W Madsen; Jill Scott-Cawiezell Journal: J Am Med Dir Assoc Date: 2011-08-04 Impact factor: 4.669
Authors: Kristine M C Talley; Jean F Wyman; Ulf G Bronas; Becky J Olson-Kellogg; Teresa C McCarthy; Hong Zhao Journal: Nurs Res Date: 2014 Mar-Apr Impact factor: 2.381