Implementing a Systematic Voiding Programme for Patients with Urinary Incontinence After Stroke

French, Beverley, Thomas, Lois Helene orcid iconORCID: 0000-0001-5218-6546, McAdam, Joanna orcid iconORCID: 0000-0001-8963-7240, Burton, Christoper, Forshaw, Denise orcid iconORCID: 0000-0001-5725-3736, Booth, Joanne, Britt, David, Cheater, Francine, Roe, Brenda et al (2016) Implementing a Systematic Voiding Programme for Patients with Urinary Incontinence After Stroke. Qualitative Health Research, 26 (10). pp. 1393-1408. ISSN 1049-7323

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We explored health professionals’ views of implementing a systematic voiding program (SVP) in a multi-site qualitative process evaluation in stroke services recruited to the intervention arms of a cluster randomized controlled feasibility trial during 2011-13. We conducted semistructured group or individual interviews with 38 purposively selected nursing, managerial and care staff involved in delivering the SVP. Content analysis of transcripts used normalization process theory as a pre-specified organization-level exploratory framework. Barriers to implementing the SVP included perceived lack of suitability for some patient groups; patient fear of extending hospital stay; and difficulties with SVP enactment, scheduling, timing, recording, and monitoring. Enablers included the guidance provided by the SVP; patient and relative involvement; extra staff; improved nursing skill and confidence; and experience of success. Three potential mechanisms of consistency, visibility, and individualization linked the SVP process with improvements in outcome, and should be emphasized in SVP implementation.

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