CLOSING THE LOOP IN AN AUDIT OF URINARY-INCONTINENCE

Urinary incontinence (UI) fulfils the criteria for an indicator condit ion of quality of cave. A records review audit in 1992 indicated that the minimum standards for history taking, physical examination and inv estigation of UI were not being met, so this was repeated in 1993 afte r full discussion with staff. 40% of the 368 patients studied met the definition of UI. In Assessment and Rehabilitation wards 57% met the s tandard for history (60% in the previous audit), 24% for examination ( 50% previously), and 86% for investigation (100% previously). As previ ously results were worse on Continuing Cave wards, where minimum stand ards were being met in only 17% for history, 14% for examination and 4 7% for investigation. However management planning had improved with ca ve plans for 71% of incontinent patients in Assessment and Rehabilitat ion wards and 97% in Continuing Cave wards. Our repeat audit has highl ighted the difficulties inherent in encouraging health professionals t o alter practice to correct apparent deficiencies.