Hip Arthritis, Hip Fractures, Urinary Retention
Conditions
Keywords
Orthopedics, Implementation, Research utilization
Brief summary
Urinary retention (UR) is a common problem in older people undergoing hip surgery. Untreated UR can lead to bladder distention and a permanent damage of the bladder, which can cause both physical and psychical suffering as well as increased costs for society. Even if national and international practice guidelines are in place for handling UR within the health care system, many fail to comply with them. Compliance to clinical practice guidelines are improved if different professions and managers collaborate as a team. In OPTION (Onset PrevenTIon of urinary retention in Orthopedic Nursing and rehabilitation) the investigators will coach multi-professional local facilitator teams in knowledge translation and implementation of UR practice as well as investigate the effects of such evidence-based practice in orthopedic nursing and rehabilitation. Implementation of research-based knowledge in evidence-based practice within an organization is complex with several known interacting factors. In a health care system these factors can be the care context, knowledge (innovation) and how the organization facilitates such implementations. The implementation strategy of OPTION utilize established theories of facilitation of knowledge implementation considering evidence and context with focus on leadership. The intervention consists of seminars and systematic support for implementation of UR-guidelines OPTION combine studies of adherence to evidence based practice regarding UR for patients over 65 years old that has undergone hip surgery and the health economic aspects of it. OPTION also contribute with improvements and increased knowledge regarding strategies to implement evidence based health care that can be used in other areas than UR and hip surgeries.
Interventions
A 12-month implementation support program for multi-professional internal facilitator teams
Sponsors
Study design
Eligibility
Inclusion criteria
Orthopaedic units in Sweden performing hip surgery. -
Exclusion criteria
Orthopaedic units in Sweden not performing hip surgery \-
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Adherence to UR guidelines in the care of patients undergoing hip surgery. | Change from base line to 1 year after the intervention | Adherence to national urinary retention guidelines documented in the patients' medical record |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Patient participation | Change from base line to 1 year after the intervention | The Patient Preferences for Patient Participation tool (The 4Ps) |
| Costs related to UR | Change from base line to 1 year after the intervention | Costs for device and labour for bladder scanning and urinary catheterization |
| The IFs', staff's, and managers' experience of UR care | Change from base line to 1 year after the intervention | Investigated with qualitative interviews |
| Number of hip surgery patients with UR | Change from base line to 1 year after the intervention | Number of hip surgery patients with UR documented in the patients' medical record |
| The experience of people undergoing hip surgery, regarding UR, UR care. | Change from base line to 1 year after the intervention | Investigated with qualitative interviews |
| The impact of a knowledge translation support program on the peoples' experience of the above | Change from base line to 1 year after the intervention | Investigated with qualitative interviews |
| The IFs', staff's, and managers' experience of the facilitation program | 1 year after the intervention | Investigated with qualitative interviews |
Countries
Sweden