The major research goal is to maintain continence in nursing home patients for a minimum six month period. It has been demonstrated that patient continence can be developed and maintained by research staff for thirty days with the use of a two hour prompted voiding treatment schedule. Follow-up measures taken when patients were returned to nursing staff for care revealed that patient continence returned to pretreatment levels within fourteen days. This project will develop and evaluate continence maintenance strategies and address the following specific goals: (1) Can a system be developed to efficiently assess the degree of patient continence over long time periods. (2) Can a staff feedback system based on continence measures be developed that will lead to continence maintenance over a six month period. 180 patients in fifteen nursing homes will be identified as potentially responsive to prompted voiding treatment according to validated prognostic criteria. Following a four day baseline period, the patients will be treated by research staff with prompted voiding procedures for six days. Patients who become continent 90% of the time will be randomly divided into experimental and control groups. The continence of both groups of patients will be monitored by research staff for a six month period. Experimental patient continence will also be monitored by supervisory nurses who will provide feedback to nursing aides. The degree such feedback assists in maintaining patient continence will be evaluated. The time costs of the supervisory feedback system will be measured and contrasted to the savings that may result from improved continence.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Project--Cooperative Agreements (U01)
Project #
5U01AG005270-05
Application #
3546241
Study Section
Nursing Research Study Section (NURS)
Project Start
1984-09-28
Project End
1991-02-28
Budget Start
1989-03-01
Budget End
1990-02-28
Support Year
5
Fiscal Year
1989
Total Cost
Indirect Cost
Name
Middle Tennessee State University
Department
Type
Schools of Education
DUNS #
077648780
City
Murfreesboro
State
TN
Country
United States
Zip Code
37132
Schnelle, J F; Newman, D; White, M et al. (1993) Maintaining continence in nursing home residents through the application of industrial quality control. Gerontologist 33:114-21
Schnelle, J F; Newman, D R; White, M et al. (1992) Reducing and managing restraints in long-term-care facilities. J Am Geriatr Soc 40:381-5
Schnelle, J F; Newman, D R; Fogarty, T E et al. (1991) Assessment and quality control of incontinence care in long-term nursing facilities. J Am Geriatr Soc 39:165-71
Schnelle, J F (1990) Treatment of urinary incontinence in nursing home patients by prompted voiding. J Am Geriatr Soc 38:356-60
Schnelle, J F; Newman, D R; Fogarty, T (1990) Statistical quality control in nursing homes: assessment and management of chronic urinary incontinence. Health Serv Res 25:627-37
Schnelle, J F; Newman, D R; Fogarty, T (1990) Management of patient continence in long-term care nursing facilities. Gerontologist 30:373-6
Schnelle, J F; Traughber, B; Sowell, V A et al. (1989) Prompted voiding treatment of urinary incontinence in nursing home patients. A behavior management approach for nursing home staff. J Am Geriatr Soc 37:1051-7
Petrilli, C O; Traughber, B; Schnelle, J F (1988) Behavioral management in the inpatient geriatric population. Nurs Clin North Am 23:265-77
Schnelle, J F; Sowell, V A; Hu, T W et al. (1988) Reduction of urinary incontinence in nursing homes: does it reduce or increase costs? J Am Geriatr Soc 36:34-9
Sowell, V A; Schnelle, J F; Hu, T W et al. (1987) A cost comparison of five methods of managing urinary incontinence. QRB Qual Rev Bull 13:411-4