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Knowledge Translation in continence care: clinical audit as an instrument of change

Knowledge Translation in continence care: clinical audit as an instrument of change. Adrian Wagg Professor of Healthy Ageing Division of Geriatric Medicine. Moving evidence into practice:. “Good practice in continence services” National Service Framework for Older People NICE guidelines

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Knowledge Translation in continence care: clinical audit as an instrument of change

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  1. Knowledge Translation in continence care: clinical audit as an instrument of change Adrian Wagg Professor of Healthy Ageing Division of Geriatric Medicine

  2. Moving evidence into practice: • “Good practice in continence services” • National Service Framework for Older People • NICE guidelines • Urinary incontinence in women • Faecal incontinence • Lower urinary tract symptoms in men (May 2010) • International Consultation on Incontinence

  3. Clinical Audit • National Audit of Continence Care for Older People • Structure (organisational factors) • Process (care for older people with UI and FI • 2005 and 2006 • Web based – excellent data quality • First National Audit to reach out from acute hospitals • Primary care • Acute care hospitals • Care homes • Mental health care (2006)

  4. Results

  5. Change management • Series of national workshops • Presentations from local participants • Action plans • Policy “pick and mix” on web

  6. Did change result? • Between the 2004 audit and 2006, in acute hospitals • Many of the organisational measures improved

  7. Did change result? • However, care indicators did not consistently improve

  8. Organisational “quality” does relate to care r= 0.44 p<0.001 Age Ageing. 2009 Nov;38(6):730-3.

  9. In the interim • There has been a consistent approach to implementation of the national guidelines for incontinence with in E&W, from many different sources. • The RCN particularly has concentrated efforts in care homes, using digital stories as a reflective tool

  10. National Audit revisited • The National Audit of Continence Care was re-run in late 2009, early 2010.

  11. Snapshot of temporal change

  12. Conclusion • Clinical audit can be used as a vehicle for positive change • Awareness and knowledge increase with use of audit • Clinical audit can probably drive change

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