Translating Clinical Research into Practice: A Randomized Controlled Trial of Exercise and Incontinence Care with Nursing Home Residents
Article first published online: 17 OCT 2002
Journal of the American Geriatrics Society
Volume 50, Issue 9, pages 1476–1483, September 2002
How to Cite
Schnelle, J. F., Alessi, C. A., Simmons, S. F., Al-Samarrai, N. R., Beck, J. C. and Ouslander, J. G. (2002), Translating Clinical Research into Practice: A Randomized Controlled Trial of Exercise and Incontinence Care with Nursing Home Residents. Journal of the American Geriatrics Society, 50: 1476–1483. doi: 10.1046/j.1532-5415.2002.50401.x
- Issue published online: 17 OCT 2002
- Article first published online: 17 OCT 2002
- practice guidelines;
- dissemination barriers;
- labor requirements
OBJECTIVES: To examine clinical outcomes and describe the staffing requirements of an incontinence and exercise intervention.
DESIGN: Randomized controlled trial with blinded assessments of outcomes at three points over 8 months.
SETTING: Four nursing homes.
PARTICIPANTS: Two hundred fifty-six incontinent residents.
INTERVENTION: Research staff provided the intervention, which integrated incontinence care and exercise every 2 hours from 8:00 a.m. to 4:00 p.m. 5 days a week.
MEASUREMENTS: Average and maximum distance walked or wheeled, level of assistance required to stand, maximum pounds lifted by arms, fecal and urinary incontinence frequency, and time required to implement intervention.
RESULTS: Intervention residents maintained or improved performance whereas the control group's performance declined on 14 of 15 outcome measures. Repeated measures analysis of variance group-by-time significance levels ranged from P < .0001 to .05. The mean time required to implement the intervention each time care was provided was 20.7 ± 7.2 minutes. We estimate that a work assignment of approximately five residents to one aide would be necessary to provide this intervention.
CONCLUSIONS: The incontinence care and exercise intervention resulted in significant improvement for most residents, and most who could be reliably interviewed expressed a preference for such care. Fundamental changes in the staffing of most nursing homes will be necessary to translate efficacious clinical interventions into everyday practice.