Ageing with Confidence; A Quality Improvement Project on Urinary Incontinence Assessment

Title: Ageing with Confidence; A QI project on Urinary Incontinence Assessment

Introduction: UI is a common yet underdiagnosed geriatric problem with a UK prevalence of >20% in individuals aged over 65. Despite its high prevalence, UI often remains untreated negatively impacting the quality of life.

Objectives: This project aimed to raise awareness and improve patient outcomes by introducing a standardised urinary incontinence (UI) assessment proforma to aid early recognition and management of UI among elderly patients admitted to the COTE ward in a district general hospital.

Methods: A retrospective snapshot of baseline data was collected over one month to identify patients with UI and evaluate current assessment practices following which a structured assessment proforma was developed based on British Geriatrics Society (BGS) CGA guidelines for UI. This included key components such as history, examination, investigations including post void scan, bladder diary and reversible causes. Educational posters were displayed on the ward and targeted teaching sessions were delivered to the multidisciplinary team.  A re-audit was performed following these interventions to measure improvement.

Results: Baseline data revealed that no patients with UI was identified (0%). Following the implementation of the proforma and the teaching sessions, identification and assessment of UI increased to 60% in the re-audit cycle along with consistent use of specific assessments (post void bladder scan, bladder diary and reversible causes) leading to lifestyle modifications, medical interventions and specialist referrals where appropriate.

Conclusion: The development and implementation of a standardised UI assessment pathway showed significant improvement in recognition and management of UI. This project showed positive outcomes on evaluation of UI and moving forward we aim to create more awareness by delivering hospital-wide teaching sessions and implementing the UI proforma as a trust-wide guideline.