Journal List > J Korean Acad Nurs > v.40(1) > 1002598

Yoon and Lee: Development of Outcome Indicators of Urinary Incontinence for Quality Evaluation in Long Term Care Hospitals

Abstract

Purpose

To develop outcome indicators of urinary incontinence to measure quality of care in long term care hospitals in Korea.

Methods

The draft indicators of urinary incontinence were developed from a literature review and clinical expert panel. A survey of medical records of 280 patients in 20 hospitals was conducted to test inter-rater reliability. Statistical analysis was done to test risk adjustment criteria, variation between hospitals, and stability of indicators, using assessment data from 77,918 patients in 623 hospitals.

Results

The inter-rater reliability of items was high (Kappa range: 0.66-0.92). Severe cognitive impairment (odds ratio [OR]: 3.15, confidence interval [CI]: 3.03-3.26) and total mobility activities of daily living (ADLs) dependency (OR: 4.85, CI: 4.72-4.98) increased the prevalence of urinary incontinence, thus they proved to be significant criteria to stratify high and low risk groups. The prevalence for low risk showed more substantial variation than the high risk group. The indicators were stable over one month.

Conclusion

This study demonstrated the feasibility of outcome indicators of urinary incontinence. Improving the reliability of the patient assessment tool and refining the indicators through validation study is a must for future study.

Figures and Tables

Table 1
General characteristics of Organizations and Patients (N=77,918)
jkan-40-110-i001

ADL=activities of daily living.

Table 2
Draft of Quality Outcome Indicator of Urinary Incontinence
jkan-40-110-i002

ADL=activities of daily living.

Table 3
Inter-rater reliability of item for Outcome Indicators of Urinary Incontinence
jkan-40-110-i003
Table 4
Test of Risk Adjustment factors
jkan-40-110-i004

ADL=activities of daily living; CI=confidence interval.

Table 5
Variance of Quality Indicator value among hospitals and Stability over time
jkan-40-110-i005

UI=urinary incontinence

Notes

This research was supported by Health Insurance Review & Assessment Service.

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