Incontinence: prevalence, management, staff knowledge andprofessional practice environment in rehabilitation units

Background. Bladder and bowel incontinence is a major health care problem, whichadversely affects the lives of many individuals living at home or in health servicefacilities. Current approaches to continence care emphasize comfort, safety andreduction of risk, rather than detailed individualized assessment and management.The literature illustrates a gap between evidence and actual practice and emphasizesthe context of care as being a key element for successful implementation of evidencebased practice.Aims. To identify prevalence of bowel and bladder incontinence and its management,investigate continence knowledge and describe the professional practiceenvironment within a rehabilitation unit for older people.Method. An integrated evaluation of continence prevalence, staff knowledge andthe work environment was adopted.Results. Findings revealed a high incidence of incontinence (60% urinary,3% faecal,37% mixed) a lack of specific continence assessment and specific rationale fortreatment decisions or continuation of care. The focus was on continence containmentrather than on proactive management. Staff demonstrated a reasonableknowledge of incontinence causation and treatment as measured by the staffknowledge audit. The evaluation of the work environment indicated a low to moderateperception of control over practice (2.39), autonomy in practice (2.87), nursedoctor relationship (2.67) and organizational support (2.67).