Effectiveness of a continuous continence program between the acute and rehabilitation phase on continence self-management among stroke patients

Abstract

　Objective: Prolonged catheterization has negative effects such as the increased incidence of catheter-related urinary tract infection（CAUTI）or the decreased ability to walk in stroke patients. This quasi-experimental study evaluated the effectiveness of a continuous continence program on continence self-management among stroke patients. Method: Participants were stroke patients with indwelling catheters in an acute care hospital（intervention group: n=70, control group: n=60）. The intervention group（IG）were enrolled in a continuous continence program between the acute phase and rehabilitation phase based on the individual's bladder volume as monitored with an ultrasound device and a voiding diary. The control group（CG）received the same continence care only in the acute phase.
　Result: The incidence of UTIs in the IG was significantly lower than in the CG（0% vs. 6.7%, p = 0.028）. The proportion of patients able to void urine in same method as before the stroke was higher in the IG than in the CG（85.7% vs. 72.9%, p = 0.070）. UTI resulted in a much higher incidence of re-indwelling catheter and longer stay in the rehabilitation ward. Conclusion: This study demonstrated that continuous comprehensive continence care for the removal of indwelling catheters lowered the incidence of UTIs by reducing the number of days stroke patients had indwelling catheters.