Using Prompted Voiding to Manage Urinary Incontinence in Nursing Homes: Can It Be Sustained?

Objectives: Studies reporting prompted voiding (PV) interventions were of short duration and were delivered by research personnel rather than nursing home staff. This study examined the effectiveness of the use of PV by nursing home staff in managing urinary incontinence among residents over a 6-month period. Design: A randomized controlled trial. Setting: Five nursing homes in Hong Kong. Participants: Data were collected from 52 nursing home residents who had been admitted to the facility for at least 6 months prior to the initiation of the study and whose incontinence had been stable over the 6-month period. Intervention: The PV intervention was delivered by the staff for 6 months. All nursing home staff were trained to ensure that they would be able to correctly deliver the intervention before initiating the intervention. The control group received the usual care. Measurements: Outcomes were defined in terms of wet episodes per day, incontinence rate per day, selfinitiated toileting per day, and total continent toileting per day. Data were collected at baseline, 3 months postintervention (T1), and 6-months postintervention (T2). Results: There were significant differences between the two groups in wet episodes per day, incontinence rate per day, and total continent toileting per day at 6 months post-intervention, with positive results found in the intervention group. A decrease of 9.1% was observed in the incontinence rate of the intervention group. Conclusions: PV was shown to have positive effects, although the effects in this study were not as powerful as those found in overseas studies. The intervention delivered by staff was sustainable for a 6month period. Nursing home operators should promote better continence care through PV, as it is a sustainable noninvasive behavioral intervention that can be mastered by staff with training. (C) 2017 AMDA The Society for Post-Acute and Long-Term Care Medicine.