Filling the void: Motivations for improving practice in stroke incontinence

Abstract

Background: Urinary incontinence is a common consequence after stroke and occurs in up to 60% of stroke survivors, and can remain prevalent in 10% of stroke survivors at 2 years. It can have severe physical and psychological consequences.[1] In 2015 the Victorian Stroke Clinical Network (VSCN) is conducting a practice collaborative to develop protocols, share learning and improve consistency of practice for stroke survivors with urinary incontinence. Aim(s): To identify health service motivations for participating in a state wide collaborative to improve practice in urinary continence management for stroke patients. Method(s): Interested health services applied using standardized forms. Application documents were independently evaluated by two reviewers and concurrent themes identified. Result(s): Eleven health services, collectively managing over 3,000 stroke patients per annum applied to be part of the VSCN Filling the Void Collaborative. Seven organizations (64%) had existing protocols for urinary incontinence. Twelve themes were identified across the applications. The most common motivations for participating in the collaborative were: National Stroke Foundation (NSF) audit findings (82%), commitment to improving care (82%), commitment to evidence-based practice (EBP) (82%), inconsistency of practice (73%), and commitment to patient centered care (73%). Discussion(s): Adherence to NSF recommendations is a key driver for practice improvement, and is consistent with Victorian health services' motivation to improve care and EBP in post-stroke urinary incontinence.