Abstract 3500: Implementing Best Practice Recommendations to Address Urinary Incontinence after Stroke
Background and Purpose: Urinary incontinence following stroke is known to have a detrimental effect on rehabilitation progress, resulting in a slower rate of recovery and less functional independence at discharge. Canadian Best Practice Recommendations for Stroke Care (2010) and the American Stroke Association Clinical Practice Guidelines (2005) recommend that a bladder training program, including timed and prompted toileting on a consistent schedule, be implemented in patients who are incontinent of urine following a stroke. Canadian Best Practice Recommendations for Stroke Care (2010) further recommend intermittent catheterization as an intervention to address urinary incontinence. The aim of the present study was to assess the extent to which the Canadian guidelines are being incorporated into clinical practice.
Methods: A retrospective chart review was conducted for consecutive stroke admissions to a neuro-rehabilitation unit in Ontario, Canada over a period of six months. Charts were reviewed for the occurrence of urinary incontinence, whether intermittent catheterization was performed, any mention of bladder training and the documentation of a bladder training protocol.
Results: One hundred and four charts were reviewed, after excluding four patients that could not be assessed for urinary incontinence due to other medical conditions. Thirty-three patients were reported to be incontinent of urine during their stay in the rehabilitation unit. Intermittent catheterization was performed for 11 patients (33.3%) with urinary incontinence. Bladder training was indicated as a therapy that was used in the rehabilitation of 16 patients (48.5%). However, a formal bladder training protocol followed by the nursing staff was only documented in 5 patients (15.2%).
Conclusions: The rehabilitation of urinary incontinence following stroke is an important issue, with a substantial number of patients failing to receive the recommended therapy. There is a need to develop strategies to promote the application of best-practice recommendations to address urinary incontinence.
- © 2012 by American Heart Association, Inc.