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  1. Article: National audit of continence care for older people: management of faecal incontinence.

    Potter, Jonathan / Peel, Penny / Mian, Sarah / Lowe, Derek / Irwin, Penny / Pearson, Michael / Wagg, Adrian

    Age and ageing

    2007  Volume 36, Issue 3, Page(s) 268–273

    Abstract: Introduction: Faecal incontinence in older people is associated with considerable morbidity but is ... for integrated continence services contained within the National Service Framework for Older People has not ... Service Framework for Older People. This study reports the results of the national audit.: Results ...

    Abstract Introduction: Faecal incontinence in older people is associated with considerable morbidity but is amenable to successful management. Quality standards in this area were previously subject to a pilot audit in primary, secondary care and care homes to allow providers to compare the care delivered by their service to others and to monitor the development of integrated continence services as set out in the National Service Framework for Older People. This study reports the results of the national audit.
    Results: Data were returned by 141 primary care sites, 159 secondary care trusts (involving 198 hospitals) and 29 care homes. Data on the care of 3,059 patients/residents with bowel problems were analysed. Fifty-eight per cent of Primary Care Trusts (PCTs), 48% of hospitals and 74% of care homes reported that integrated continence services existed in their areas. Whilst basic provision of care appeared to be in place, the audit identified deficiencies in the organisation of services and in the assessment and management of faecal incontinence.
    Conclusion: The results of this audit indicate that the requirement for integrated continence services contained within the National Service Framework for Older People has not yet been met. Basic assessment and care by the professionals directly looking after older persons is often lacking. There is an urgent need to re-establish the fundamentals of continence care into the daily practice of medical and nursing staff, and undoubtedly, action needs to be taken with regard to the establishment of truly integrated, quality services in this neglected area of practice.
    MeSH term(s) Aged ; Aged, 80 and over ; Attitude of Health Personnel ; Fecal Incontinence/epidemiology ; Fecal Incontinence/therapy ; Health Knowledge, Attitudes, Practice ; Health Services Accessibility/standards ; Health Services Needs and Demand/standards ; Health Services for the Aged/organization & administration ; Health Services for the Aged/standards ; Health Services for the Aged/statistics & numerical data ; Homes for the Aged/standards ; Hospital Administration/standards ; Humans ; Medical Audit/statistics & numerical data ; National Health Programs/organization & administration ; National Health Programs/standards ; National Health Programs/statistics & numerical data ; Nursing Homes/standards ; Outcome and Process Assessment (Health Care) ; Patient Satisfaction ; Practice Guidelines as Topic ; Primary Health Care/standards ; Program Evaluation ; Quality of Health Care/standards ; Quality of Health Care/statistics & numerical data ; State Medicine/organization & administration ; State Medicine/standards ; State Medicine/statistics & numerical data ; United Kingdom/epidemiology
    Language English
    Publishing date 2007-05
    Publishing country England
    Document type Comparative Study ; Journal Article ; Multicenter Study
    ZDB-ID 186788-x
    ISSN 1468-2834 ; 0002-0729
    ISSN (online) 1468-2834
    ISSN 0002-0729
    DOI 10.1093/ageing/afm004
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: National audit of continence care: adherence to National Institute for Health and Clinical Excellence (NICE) guidance in older versus younger adults with faecal incontinence.

    Harari, Danielle / Husk, Janet / Lowe, Derek / Wagg, Adrian

    Age and ageing

    2014  Volume 43, Issue 6, Page(s) 785–793

    Abstract: ... treatment of faecal incontinence (FI) in older people.: Objective: the 2009 audit assessed adherence ... in some indicators in older people with successive audits suggests that ongoing national audit with linked ... Background: previous UK National Audits of Continence Care showed low rates of assessment and ...

    Abstract Background: previous UK National Audits of Continence Care showed low rates of assessment and treatment of faecal incontinence (FI) in older people.
    Objective: the 2009 audit assessed adherence to the National Institute for Health and Clinical Excellence guidelines on management of FI and compared care in older versus younger patients.
    Methods: fifteen older (65+) and 15 younger (18-65) patients with FI were to be audited in hospital (inpatient or outpatient), primary care (PC) and care home sites.
    Results: data were submitted for n = 2,930 cases from 133 hospitals, n = 1,729 from 97 PC surgeries and n = 693 from 63 care homes. Bowel history was not documented in 41% older versus 24% younger patients in hospitals and 27 versus 19% in PC (both P < 0.001). In older people, there was no documented focused examination in one-third in hospitals, one-half in PC and three-quarters in care homes. Overall, <50% had documented treatment for an identified bowel-related cause of FI. FI was frequently attributed to co-morbidity. Few patients received copies of their treatment plan. Quality-of-life impact was poorly documented particularly in hospitals.
    Conclusions: this national audit shows deficits in documented assessment, diagnosis and treatment for adults with FI despite availability of clinical guidance. Overall care is significantly poorer for older people. Clinicians, including geriatricians, need to lead on improving care in older people including comprehensive assessment where needed. Improvement in some indicators in older people with successive audits suggests that ongoing national audit with linked information resources can be useful as both monitor and agent for change.
    MeSH term(s) Adolescent ; Adult ; Age Factors ; Aged ; Communication ; Critical Pathways/standards ; Fecal Incontinence/diagnosis ; Fecal Incontinence/epidemiology ; Fecal Incontinence/therapy ; Female ; Guideline Adherence/standards ; Humans ; Male ; Medical Audit ; Middle Aged ; Outcome and Process Assessment (Health Care)/standards ; Patient Discharge Summaries/standards ; Physician-Patient Relations ; Practice Guidelines as Topic/standards ; Practice Patterns, Physicians'/standards ; Quality Indicators, Health Care/standards ; Quality of Life ; Risk Factors ; Social Support ; Treatment Outcome ; United Kingdom/epidemiology ; Young Adult
    Language English
    Publishing date 2014-11
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 186788-x
    ISSN 1468-2834 ; 0002-0729
    ISSN (online) 1468-2834
    ISSN 0002-0729
    DOI 10.1093/ageing/afu056
    Database MEDical Literature Analysis and Retrieval System OnLINE

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