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Keywords:

  • Assessment;
  • Evidence-based practice;
  • Guidelines;
  • Professional development;
  • Urodynamics

ABSTRACT

The translation of clinical guidelines into practice is a complex process, primarily because it is a ‘top down’ approach to disseminating information. The aim of this study was to determine whether current guidelines and standards have been applied to everyday urodynamic practice, and establish how health care professionals have interpreted the terminology. It was also an ideal opportunity to explore the systems in place that support personal and professional development, and identify factors that can contribute to, or obstruct, ‘good’ urodynamic practice. A descriptive exploratory research design was adopted using a mixed methodological approach. A purposive sample (n = 60) of doctors, nurses and technicians who currently undertake urodynamic investigations within one NHS region were identified. Most of the participants were familiar with the International Continence Society guidelines; with over half routinely using them in their current practice. Although there was a comprehensive uptake of formal urodynamic training courses, there was limited evidence of formal assessment either before or after training/education. This was also reflected in some of the themes that emerged during the semi-structured interviews; access to supervision, multidisciplinary team meetings, team working, networking, isolation, attitudes and time, were all identified as factors that could have either a positive or negative effect on urodynamic practice. These findings confirm that guidelines, in one NHS region, are reaching their target population. However, the translation of training and assessment into practice is a complex issue to address, as it requires skills in reflective practice, self-assessment and critical analysis. Although guidelines/recommendations exist, a more robust framework may be required; incorporating structured mentoring and clinical assessment with experienced practitioners, in order to address the barriers that clearly exist.