Abstracts – Podium Presentations from the 33rd National Conference on Incontinence (NCOI)

1. Improving clinical management of urinary tract infections in Australian residential aged care homes

Lyn-li Lim¹, Melanie Wroth¹, Kathleeen Williams¹, Juanita Breen¹

¹Aged Care Quality And Safety Commission, Melbourne, Australia

Objective: Overdiagnosis of urinary tract infection (UTI) is common in Australian residential aged care homes (RACHs).¹ Behaviour change, delirium, falls, and urinary incontinence in older people are often incorrectly attributed to UTIs. Inappropriate urine dipstick testing and interpretation of results also contributes. ‘To Dip or Not to Dip’ (TDONTD)² is a quality improvement intervention that aims to improve antibiotic prescribing for UTIs by reducing low-value dipstick testing. Core components are:

This study aimed to evaluate TDONTD implementation in Australian RACHs.

Methods: From October 2021 to July 2022, a before–after process evaluation of a multi-site implementation study was undertaken in 12 RACHs. This involved interviews with onsite nursing staff and pharmacists contracted to RACHs who championed delivery of TDONTD. Surveys of self-reported dipstick testing practice and antibiotic audits were collected.

Results:

Fig. 1.

Before and after antibiotic prescribing appropriateness.

Key barriers to TDONTD were beliefs about capabilities of nursing staff in diagnosing infection without dipstick testing, beliefs about consequences (fear of missing infection), and social influences (pressure from family, doctors and hospitals).

Key enablers to TDONTD were perceived increased staff knowledge (around clinical presentation of UTI, ASB, other causes of falls and behaviour change), resources from a credible source, empowering nurse champions to deliver operational change initiatives, pharmacist skills in delivering education, and organisational policy or process change.

Conclusions: There are widespread gaps in knowledge around recognising and diagnosing UTIs, ASB and usefulness of dipstick testing to confirm UTI in older people. Beliefs around how UTIs clinically present and importance of dipstick testing are deeply ingrained. TDONTD can deliver changes in practice, beliefs and improve antibiotic prescribing for UTI in RACHs. Broader work is required to promote awareness of low-value dipstick testing in older people amongst healthcare professionals, consumers and families.

Ethics approval: Approved as a Quality Assurance activity by the Office or Research and Ethics Eastern Health (QA21-041).

Conflicts of interest: No authors have any actual or potential declarations to make.

Funding: Project evaluation was funded by the Aged Care Quality and Safety Commission.

Reference

1 Australian Government. Infection and antimicrobial prescribing in Australian residential aged care facilities – Results of the 2022 Aged Care NAPS; 2024. Available at https://www.amr.gov.au/resources/infection-and-antimicrobial-prescribing-australian-residential-aged-care-facilities-results-2022-aged-care-naps [accessed 7 January 2025]

2 Aged Care Quality and Safety Commission. Antimicrobial Stewardship. Available at https://www.agedcarequality.gov.au/providers/clinical-governance/antimicrobial-stewardship [accessed 7 January 2025]

2. Understanding the prevalence of delayed toilet training, contributing factors and opportunities to address

Nives Zerafa¹

¹Continence Foundation Of Australia, Surrey Hills, Australia

Introduction and Objectives: Developing good toileting habits from an early age is linked with continence in later life.¹ Toilet training in many children is delayed for different reasons and may cause complications later in life with their bladder and bowel control health. Delayed toilet training is defined as a child not being toilet trained by the age of four and it can have significant consequences for children’s physical, psychological and social wellbeing. Anecdotal evidence shows increasing incidences of delayed toilet training in children.

Our aim was to better understand the prevalence of and issues contributing to delayed toilet training, to be able to better address the needs of children, families/carers and the workforce, to minimise preventable² incontinence and limit its effects. This was guided by the organisation’s Health Promotion Framework for prevention of incontinence.

Methods: We undertook a number of activities to develop this understanding:

Findings: We learned that:

Conclusions: The findings show increasing prevalence of delayed toilet training and a range of factors that contribute to this. The findings have assisted us to identify: the need for more promotion of the importance of timely independent toileting for all children to prevent lifelong continence issues; the gaps in current information and supports and opportunities for improvements; and the potential to work in partnership with the early childhood sector to improve outcomes and engagement with families.

This improved understanding of toilet training from a range of perspectives provides the detail needed to inform the next steps and will support development of a detailed strategy and plan to best support independent toileting in children and families, care providers, and early educators to reduce the prevalence of incontinence in later life.

Ethics approval: Not required.

Conflicts of interest: the author has no actual or potential declarations to make.

Funding: Victorian Government under the Home and Community Care Program for Young People.

Reference

1 Caldwell PH, Sureshkumar P, Kerr MI, Hamilton S, Teixeira-Pinto A, Macaskill P, Craig J. A randomised controlled trial of a code-word enuresis alarm. Arch Dis Child 2015; 101(4):–331. doi:10.1136/archdischild-2015-308564

2 World Health Organisation. Ottawa Charter for Health Promotion. Canada: World Health Organisation; 1986. Available at https://www.who.int/teams/health-promotion/enhanced-wellbeing/first-global-conference

3 Data sourced May 2023 from responses to the Australian Early Development Census (2009 to 2021) item worded ‘Would you say that this child is independent in toileting habits most of the time?’ Raw data is confidential.

3. Experiences of transition from paediatric to adult care: urinary incontinence within New South Wales

Jessica Sun^1,2, Isabella Nilsson², Saurav Jain², Patrina Caldwell³

¹Sydney Children’s Hospital, Sydney, Australia

²The University of Sydney, Sydnye, Australia

³Children’s Hospital at Westmead, Sydney, Australia

Objective: Transition care can be complex and challenging for young people moving from a paediatric to an adult focused health care setting. Suboptimal transition may lead to poor chronic disease management, psychological stress, and greater morbidity and mortality.¹ Urinary incontinence (UI) carries a significant burden of disease and negatively impacts quality of life.² This project aims to understand the lived experiences, views, and ideas of young people with UI, with a goal to characterise and improve their experience of transition.

Methods: Recruitment of participants occurred at specialist adolescent bladder clinics or through recommendations of treating clinicians including paediatricians, paediatric urologists and adult urologists. Young people with urinary incontinence completed virtual semi-structured video interviews with or without their guardians present. Interviews were videotaped and transcribed in a de-identified manner and coded by two independent researchers, using grounded theory thematic analysis to identify patterns and themes including readiness for transition, perceived enablers and barriers to successful transition, and overall transition experience.

Results: Saturation was reached after twelve interviews. There were seven male, and five female participants aged between 13 and 21 years old. The interview revealed four key themes of (1) Feelings and emotions, (2) Knowledge and communication, (3) Readiness for transition, and (4) Transition experiences that acted as enablers or barriers of transition.

Conclusions: Young people with urinary incontinence experience feelings of denial, avoidance, discomfort, and embarrassment. Young people and their parents report late initiation of transition and lack of communication and handover as barriers to successful transition. Further research should aim to identify the underlying causes of these barriers and the role of dedicated transitional services to improve on the experiences of young people with urinary incontinence.

Ethics approval: 2021/ETH12019.

Conflicts of interest: No authors have any actual or potential declarations to make.

Funding: None.

Reference

1 Shepard CL, Doerge EJ, Eickmeyer AB, Kraft KH, Wan J, Stoffel JT. Ambulatory care use among patients with spina Bifida: change in care from childhood to adulthood. J Urol 2018; 199(4): 1050–5. doi:10.1016/j.juro.2017.10.040

2 Yeung CK, Sihoe JDY, Sit FKY, Bower W, Sreedhar B, Lau J. Characteristics of primary nocturnal enuresis in adults: an epidemiological study. BJU Int 2004; 93(3): 341–5. doi:10.1111/j.1464-410x.2003.04612.x

4. Real-world evidence study leveraging large-scale datasets in paediatrics care

Sonya Meyer¹, Julia Veldhuizen van Zanten², Bruce Meyer¹, Jannat E Yeasmin², Valer Pop²

¹Biomedial Devices, Australia

²LifeSense Group, Eindhoven, Netherlands

Hypothesis/aims of study: This study is based on 17,159 children’s enuresis and sleep data, aged between 3 and 16 years and suffering from enuresis condition. The aim of this real-world study is to show the evidence and effectiveness of leveraging large-scale datasets in paediatrics care.

Study design, materials and methods: Data collection was performed using the Oopsie Heroes sensor. It was attached to the underwear or pyjama trousers of the patient, the application was activated, and the mobile device placed in the same room with the patient. In case of an enuresis event, the sensor detected urine in the underwear using a sensitive impedance measurement and emitted a pulsating frequency sound which the application on the mobile device detected. As a result of an enuresis event, the mobile emitted within less than 5 seconds a wake-up signal that alerted the patient and the parents/carers.

The large-scale dataset includes parameters such us: the child age and gender, the time the child goes to sleep, accurate time (at seconds level) of all the enuresis events, accurate time (at seconds level) of the child wake-up moment, the enuresis improvement over time (defined as reduction in the enuresis events frequency over time), the used wake-up alarm type (e.g. recorded voice of the parents), etc. Alongside, for children groups with autism and ADHD, the clinicians can decide better tailored diagnostics and treatment strategies: for example, we have learned from our studies that using the voice of the parents (mothers voice for boys and fathers voice for girls) to wake-up these children groups, can greatly improve the treatment effectiveness (due to a faster wake-up time reaction versus other used alarms) and reduce the time these children groups can reach dry nights.

Results: The average age of the 17,159 patients was 7.8 years (SD = 1.8). We have collected over 1 million enuresis and sleep data points such as: patient age, gender, time to go to bed, enuresis patterns, enuresis prevalence, time to wake-up, improvement in the bladder control over time, etc.

Interpretation of results: The gender division of (65% boys, 35% girls) correlates with research indicating a 2/3 vs 1/3 division between boys and girls.^1,2 See Fig. 1a. Alongside, based on the measured (see Fig. 1b, n = 4800 patients) and collected patients feedback we see that after using the sensor patient’s enuresis frequency events decreased and the bladder control and retention improved. From this we conclude that patients using an enuresis alarm can learn to control their bladder during the day or at night. This is in keeping with the current research.^2,3

Fig. 1.

Concluding message: The Oopsie Heroes demonstrates it is an effective system to: (1) collect large-scale datasets about enuresis and sleep patterns (2) provide an overview of events to parents/carers (3) help patients alert on time after an enuresis event takes place. The big data can especially be of value to healthcare professionals interested in understanding and tracking the enuresis prevalence/pattern, identifying the relationship between autism, ADHD and enuresis, assess the medication results, decide better tailored diagnostics and treatment strategies and improve the patient's quality of life.

Ethics approval: Not required.

Conflicts of interest: No authors have any actual or potential declarations to make.

Funding: None.

Reference

1 Nieuwhof-Leppink AJ, Schroeder RPJ, van de Putte EM, de Jong TPVM, Schappin R. Daytime urinary incontinence in children and adolescents. Lancet Child Adolesc Health 2019; 3(7): 492–501. doi:10.1016/S2352-4642(19)30113-0

2 Doleys DM, Behavioral treatments for nocturnal enuresis in children: a review of the recent literature. Psychol Bull 1977; 84(1): 30–54. doi:10.1037/0033-2909.84.1.30

3 Baker H. Practical solutions to help parents deal with childhood enuresis. London, England 2001; 17(2): 133–136.

5. Understanding consumer and healthcare professional decision-making regarding medications for urinary incontinence for people with dementia

Amanda J Cross¹, Joan Ostaszkiewicz², Anne Nileshni Fernando¹, J Simon Bell¹

¹Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Australia

²National Ageing Research Institute, Parkville, Australia

Background: Urinary incontinence is a distressing and stigmatised condition that can impact quality of life for individuals living with dementia. While non-pharmacological management is first-line for management of urinary incontinence, more than one third of people also use medications to help manage symptoms. Unfortunately, medications commonly used for urinary incontinence, such as anticholinergics, are often not recommended for people living with dementia due to high risk of harmful side effects.

Objective: To explore perspectives and decision-making regarding the use of medications to help manage symptoms of urinary incontinence for people living with dementia.

Methods: Semi structured interviews were conducted with people living with dementia, carers and healthcare professionals. Participants were recruited via an expression of interest process using a broad advertising strategy involving both purposive and snowball sampling. Interviews were recorded, transcribed and thematically analysed using a deductive approach based on the World Health Organization six step Guide to Good Prescribing.¹

Results: 31 participants were interviewed, including people living with dementia (n = 3), carers (n = 9), prescribers (n = 5), pharmacists (n = 7) and nurses (n = 7). Participants reported that urinary incontinence is often identified incidentally as people living with dementia are reluctant to discuss and healthcare professionals often don’t proactively discuss, urinary incontinence (step 1: identify urinary incontinence). Participants felt that symptoms of urinary incontinence are generally measured subjectively, with prescribers triangulating reports of symptoms using feedback from the patient, carers and other healthcare professionals. Goals of treatment varied, and included to improve quality of life, reduce incontinence episodes and reduce caregiver burden associated with incontinence (step 2: therapeutic objective). Participants mentioned that choosing the most appropriate medication requires careful consideration of goals of care, comorbidities, potential side effects and medication cost (step 3: selecting medication) and is often a difficult decision due to a lack of evidence, lack of options and lack of appropriate resources to guide decision making (step 4: starting medication). Healthcare professionals highlighted the importance of discussing and documenting expectations and risks when starting treatment, but provision of written information to consumers was limited and consumers often felt they were not provided information on different options for treatment (step 5: provision of information). Participants described the importance of monitoring for side effects when starting medication for urinary incontinence, however ongoing monitoring of harms and benefits was limited. Deprescribing was generally only considered when adverse events occurred or palliative care commenced (step 6: monitoring).

Conclusions: Our findings highlight the complexity of decision-making regarding prescribing, monitoring and deprescribing medications for urinary incontinence in people living with dementia. The next phase of the project is to codesign resources to support people living with dementia, their carers and healthcare professionals to make informed decisions to ensure safe and appropriate use of medications for urinary incontinence.

Ethics approval: Monash University Human Research Ethics Committee Approval ID 42314.

Conflicts of interest: AJC has received grant or consulting funds from the Medical Research Future Fund, Dementia Australia Research Foundation and the Pharmaceutical Society of Australia. All these funds were paid to the administering University. AJC is also a national board director for the Pharmaceutical Society of Australia.

Funding: Dr Stuart And Bonnie Bartle Project Grant, Dementia Australia.

Reference

1 De Vries TPGM, Henning RH, Hogerzeil HV, Fresle D, Policy M, Health Organization World. Guide to good prescribing: A practical manual. World Health Organization, Geneva; 1994.

6. The Australasian Pelvic Floor Procedure Registry: key findings from aggregate clinical data

Aruna Kartik¹, Natalie Heriot¹, Susannah Ahern¹

¹Monash University, Melbourne, 553 St Kilda Road

Introduction: The Australasian Pelvic Floor Procedure Registry (APFPR) monitors the safety and outcomes of pelvic floor procedures (PFP) performed to treat Stress Urinary Incontinence (SUI) and Pelvic Organ Prolapse (POP), including those that involve pelvic mesh or prosthesis.¹ It systematically collects and analyses clinical and patient-reported outcome measures (PROMs), providing feedback to health services to support clinical quality improvement.

Objective: To describe key reporting activities of the APFPR, present examples of aggregate clinical data, and note key findings.

Methods: The APFPR dataset includes primary procedures (i.e. first procedure to treat a diagnosis) and subsequent procedures (to manage recurrence and complications, including mesh excisions) relating to all SUI procedures and mesh-related POP procedures. Process and outcome indicators relating to assessment, procedure efficacy, and adverse outcomes are monitored. Six-monthly benchmarked reports are provided to individual sites with minimum data volumes per period.

Results: As of December 2024, approximately 1,300 PFPs had been entered in the registry. Seventy-nine percent of procedures captured were to treat SUI; 21% to treat POP (with or without SUI). The majority of procedures overall (71%) were primary procedures; these represented 73% of all SUI procedures and 60% of all POP (±SUI) procedures.

Of Primary SUI procedures, 56% were mesh slings, 34% were bulking agents and 10% were native tissue procedures. The most common mesh used for primary slings was Gynecare TVT exact (77%), and the most common bulking agent used was BULKAMID (93%). Of native tissue slings, the most common method used was rectus fascia (56%). Outcomes from these procedures were 95% improvement for patients who had mesh slings or native tissue procedures, with 72% of patients having bulking agents reporting post-operative improvement. A total of 166 primary POP procedures were captured, of which 76 had concomitant SUI. Improvement was seen in over 98% of primary POP (±SUI) procedures.

Subsequent procedures following previous initial procedures were most commonly undertaken for recurrence- 51% of subsequent SUI procedures, and 62% of subsequent POP procedures were performed to treat recurrence. The remainder of subsequent procedures were those performed to manage complications of previous surgeries including mesh excisions. Improvement following subsequent SUI procedures occurred in 77% of SUI recurrence procedures, 70% of procedures to manage complications, but only in 26% of mesh excision procedures. It was also noted that 34% of the mesh excision cohort reported being worse off after the procedure. Improvement following subsequent POP recurrence procedures was 86%. Following POP mesh excision, 20% reported improvement and 80% reported no change.

Clinical quality indicators showed high completion of process measures and overall very high efficacy, with low proportions of post-operative complications. Benchmarked Hospital reports showed variation in procedures and patient outcomes, largely aligned to the aggregate findings (presentation of example site report).

Conclusions: Despite being a young registry, the APFPR is rapidly maturing and able to provide increasingly meaningful data at aggregate and hospital levels. Registry data has significant potential to identify factors associated with better patient outcomes, and support local quality improvement.

Ethics approval: Not required.

Conflicts of interest: No authors have any actual or potential declarations to make.

Funding: The APFPR is supported by funding from the Australian Government, Department of Health and Aged Care, under the National Clinical Quality Registry Program.

Reference

1 Ahern S, Lassetter C, Tapley K, Heriot N, Ruseckaite R, Hansen J, et al. The Australasian Pelvic Floor Procedure Registry Annual Report 2023. Melbourne: Monash University, School of Public Health and Preventive Medicine; 2023. No. 2: 61 p. Available at https://apfpr.org.au/annual-report-2023/

7. Flushing away fears: a behavioural approach to nappy-dependent encopresis and toilet anxiety in children

Renee Collins¹

¹Super Kids Behavioural Consulting, 9/56 Buffalo Road, Australia

Objective: A common sub-group of children with encopresis are those who request a nappy for their bowel movement, which may indicate that their encopresis could be volitional in nature. These children often have urine continence, wear underpants and don’t often have ‘accidents’, but instead refuse to use the toilet for a bowel movement and will insist on a nappy. This is often extremely frustrating for their parents and it is not always able to be effectively managed by primary care health providers. This sub-group of children are often difficult to toilet train using conventional toilet training methods and it often leads to further poor mental, behavioural and health outcomes and complications, such as constipation and increased anxiety.¹

Design and Methods: A multiple baseline across participants design was used to detect the effect of the training program on correct defecations. A behavioural based intervention program to toilet train 10 neurotypical and neurodivergent children who demonstrated no prior toilet training success, was implemented by the child’s primary carer. The Nappy Fading ‘transfer of stimulus control’ procedure² consisted of establishing a schedule of in-nappy defecation and the child was presented with a series of individualised challenges relating to what they’re wearing (nappies or underwear), where they are during the bowel movement (for example, their preferred location behind the couch, bathroom or on the toilet) and then provided with a reward for meeting the challenge.³ The challenges and expectations gradually increase proximity to the toilet, until they sit on the toilet and then progressively transferring stimulus control by gradually fading out the presence of the nappy.

Results: The current study demonstrates that for children with toilet anxiety or who demonstrate a fear of the toilet, using a Nappy Fading approach is an effective behavioural intervention. The program was successful and resulted in across 8 out of 10 cases being completely toilet trained and the remaining two made progress that their parents were satisfied with. Qualitative feedback from caregivers underscored the importance of tailoring interventions to family values and the child’s unique needs.

Practice implications: It is important that paediatric primary care health providers are aware of these step-wise behaviourally based solutions and how to best implement them. Providers must determine the behavioural function of the nappy dependence to then decide on a suitable behavioural approach. A decision matrix will be presented to help clinicians determine the function of the inappropriate soiling.

Conclusions: Toilet training is a complex process that can be affected by anatomic, physiologic and behavioural conditions. Addressing encopresis, nappy dependence and toilet anxiety requires a tailored, evidence-based approach. The Nappy Fading method offers a gradual, anxiety-reducing pathway from nappy use to successful toilet habits. This allows for a gradual acquisition of toileting skills in a manner that reduces anxiety, resistance, increases cooperation and participation for the child. For children with developmental delays, this can be particularly effective as it accommodates their unique learning pace and reinforces small, incremental successes.

Ethics approval: Not required.

Conflicts of interest: The author has no actual or potential declarations to make.

Funding: None.

Reference

1 Johnson JV, Travers JC, Forbes HJ, Zimmerman K. A systematic review of rapid toilet training intervention intensity for individuals with intellectual and developmental disabilities. Educ Train Autism Develop Dis 2021; 56(2): 140–157.

2 Luiselli JK. A case study evaluation of a transfer-of-stimulus control toilet training procedure for a child with a pervasive developmental disorder. Focus Autism Other Develop Dis 1996; 11158–162.

3 Luiselli JK. A transfer- of -stimulus control prompting procedure applicable to toilet training programs for children with developmental disabilities. Child Fam Behav Ther 1996; 18 29–34.

8. Lifting the lid on male incontinence: BINS4Blokes partners with shopping centre leaders to boost independence

Vicky Pentney¹

¹Continence Foundation Of Australia, 1/407 Canterbury Road, Surrey Hills, Australia

Introduction: Incontinence is a prevalent condition, affecting an estimated 2.4 million Australian men.¹ The prevalence of incontinence is underreported due to the stigma surrounding this condition. Men living with incontinence depend on the provision of disposal bins to discard used continence products, yet unlike women's public toilets, men’s toilets often lack essential facilities. The absence of bins in male toilets is known to contribute to increased rates of social isolation, resulting from a reluctance for men living with incontinence to leave their home.² This can lead to the onset of depression and ongoing mental health and wellbeing issues.³

The BINS4Blokes campaign advocates for installation of incontinence product disposal bins in male toilets Australia wide, ultimately improving the health and wellbeing of men with incontinence.

Objective: Since shopping centre toilet facilities are commonly viewed as accessible, safe, and clean, our objective was to engage with the shopping centre leaders to advocate for the installation of bins in male toilet facilities, Australia wide.

Methods: We ran two discreet promotion activities targeting shopping centres

To understand public perceptions of where incontinence bins are needed, we partnered with Convenience Advertising to implement a nationwide communications campaign, utilising QR code scans to gather pledges and insights from shopping centre patrons. Convenience Advertising installed 513 A4 static panels in 41 high traffic shopping centres, including male, female, and communal toilets, from November 2022 to June 30, 2023.

Results/findings outcomes: The Convenience Advertising project was estimated to reach 5,634, 294 shopping patron visits per week and resulted in 4,690 scans and 2,629 pledges from those patrons This response highlighted a strong need for more bins and provided a solid rationale for our continued advocacy efforts within the shopping industry retail sector.

We then partnered with The Shopping Centre News (SCN) to engage with shopping centre leaders responsible for key decision making. We promoted the BINS4Blokes initiative through the development of four editorials and a dedicated content piece, highlighting the importance of installing disposal bins in male toilets.

Shopping Centre News is highly regarded by Retail Managers, CEOs, and Operations Managers within the shopping centre industry. With its strong digital presence, SCN generally attracts 7,500 e-newsletter subscribers, 60,000 visitors to the website and reaches and audience of 80,000 through social media platforms.

The Shopping Centre News editorials generated exceptional audience engagement, attracting interest from shopping centre leaders. The BINS4Blokes content piece achieved a remarkable 44.27% open rate, surpassing industry standard of 24.3% and SCN benchmark of 39.9%. This strong response has led to an estimated eight new BINS4Blokes, supporters, with potential for additional unreported supporters.

Conclusions: The BINS4Blokes campaign has effectively highlighted the urgent need for incontinence product disposal bins in male toilets in shopping centres. By engaging over 5.6 million shopping centre patrons through targeted communications and collaborating with The Shopping Centre News to reach industry leaders, the campaign has demonstrated strong public and stakeholder interest.

These successes provide a robust foundation for ongoing engagement with the shopping centre industry and present significant opportunities to expand the number of industry leaders supporting BINS4Blokes.

Ethics approval: Not required.

Conflicts of interest: The author has no actual or potential declarations to make.

Funding: National Continence Program (NCP).

Reference

1 Deloitte Access Economics. The economic cost of incontinence in Australia; 2024. Continence Foundation of Australia. Available at https://www.continence.org.au/about-us/our-work/economic-cost-incontinence

2 Continence Foundation of Australia. 2023 National Consumer Survey Analysis; 2023. Available at https://www.continence.org.au/sites/default/files/2024-03/National%20Consumer%20Survey%20Analysis%20Report%202023_External_18032024_LR.pdf

3 Avery JC, Stocks N. Urinary incontinence, depression, and psychological factors – A review of population studies. EMJ Urol 2016; 1(1): 58–67.

9. Leading change – a case study of connecting effectively with consumers about continence health

Joanne Sinclair¹

¹Continence Health Australia, Suite 1, 407 Canterbury Rd, Surrey Hills, Australia

Introduction: As a responsive health focused organisation, we partner with people with lived experience of incontinence to make sure our services, programs and resources are accessible and appropriate for consumers. Consumer and community partnerships are driven by the:

In 2024 we designed and delivered a consumer event – Let’s Talk – menopause and continence webinar – using the organisation’s Partnering with Consumers Framework.

The Framework³ supports partnering with and building the capacity of consumers to enhance the programs and services of the organisation, in this case a consumer event.

Objective: To find out if the Framework was effective in supporting the design and delivery of a webinar that meets the needs of consumers.

Methods: We mapped the development of the consumer event against the key processes for partnering with consumers in the Framework to show how they contributed to a successful event.

Results/findings/outcomes: The following key processes for engagement, participation and capacity building in the Framework were used to support the development and delivery of the webinar (Fig. 1).

Fig. 1.

The CAC (shown in grey) supported the development of the consumer event while the other processes supported its delivery.

Consumer Advisory Committee (CAC)

A consumer event planning session was held with this Board Committee. The CAC identified that we should hold the event online; include lived experience of incontinence to raise awareness of incontinence; ensure it was welcoming and engaging. They advised that consumer events with a clear target audience had worked well previously.

Continence Consumer Network (CCN)

The CCN is the organisation’s group of consumers with lived experience of incontinence, carers or with an interest in continence health. A lived experience presenter was selected from the CCN to present at the event.

Training

Free training for consumers joining the CCN provides them with a comprehensive understanding of their role and the opportunities available to contribute to the organisation’s work.

Reimbursement

Incentive for the lived experience presenter recognised the value of their personal story shared with a large audience.

Ongoing feedback and reflection

A feedback survey was sent to all attendees after the webinar, with 75 responses.

The respondents’ feedback was positive overall about the webinar content and format. It was clear that the content and structure of the webinar were a good fit for the attendees.

The success of partnering with consumers to develop and deliver the webinar was evident in the audience and engagement data:

Conclusions: The mapping of the development and delivery of the consumer event against key Framework processes showed that the Framework was effective in meeting the needs of consumers. Partnering with consumers was an important way to lead change by increasing engagement, relevance and dignity on menopause and continence.

Ethics approval: Not required.

Conflicts of interest: The author has no actual or potential declarations to make.

Funding: National Continence Program (NCP).

Reference

1 Australian Commission on Safety and Quality in Health Care. Australian Charter of HealthCare Rights; 2020. Available at https://www.safetyandquality.gov.au/our-work/partnering-consumers/australian-charter-healthcare-rights

2 Australian Commission on Safety and Quality in Health Care. Partnering with Consumers Standard. National Safety and Quality Health Standards; 2024. Available at https://www.safetyandquality.gov.au/standards/primary-and-community-healthcare/partnering-consumers-standard

3 Continence Foundation of Australia. Partnering with Consumers Framework; 2021. Available at https://www.continence.org.au/sites/default/files/2022-02/Partnering%20with%20Consumers%20Framework%202021.pdf

10. The design and validation of resources for indwelling urinary catheter care in aged care homes

Joan Ostaszkiewicz^1,2,3,4, Frances Batchelor¹, Wendy Taylor¹, Andrew Gilbert¹, Elizabeth Watt¹, Caitlin Tay¹

¹National Ageing Research Institute, Parkville, Australia

²The University of Melbourne, Parkville, Australia

³Federation University, Ballarat, Australia

⁴The Geller Institute for Ageing and Memory, West London, United Kingdom

Objective: To describe the process undertaken to design and validate catheter care resources to support aged care providers to implement effective, data driven quality assurance and performance improvement programs that improve the care and lives of people with indwelling urinary catheters who use their services.

Methods: We adopted a mixed methods participatory approach that involved triangulation of data from primary research, guidelines and regulation related to aged care, with three key stakeholder groups: (i) people with experience of receiving catheter care in an aged care home and/or their families, (ii) aged care employees with experience of delivering catheter care in an aged care home, and (iii) academic and/or clinical experts. Feedback on drafts of each resource was obtained through personal communication via email or meetings and structured workshops. Experts who reviewed the online catheter care courses completed appraisal forms and were invited to comment against each criterion. The project team systematically reviewed all feedback, discussed it in depth with a view to incorporating it into emergent drafts. Table 1 details the resource type, the stakeholder type and the number of people who reviewed the resource and provided feedback.

Results: The review of literature yielded information about catheter care bundles and a best practice guideline from the European Association of Urological Nurses.¹ This informed the learning outcomes and content of the courses and was also used to draft the audit tool and capabilities. Stakeholder feedback led to several refinements, including strengthened content about emotionally supporting a person with a urinary catheter and ten overarching catheter care principles that were mapped to the new draft strengthened quality standards for aged care.²

Conclusions: Having designed and validated the resources, the next step involves establishing their feasibility through a multi-centre, facility-level cluster randomised control trial.

Ethics approval: HREC/107165/Austin-2024.

Conflicts of interest: No authors have any actual or potential declarations to make.

Funding: Medical Research Future Fund (MRFF)– Clinician Researchers Initiative- 2022 Clinician Researchers: Nurses, Midwives and Allied Health Grant Opportunity – Stream 1.

Reference

1 Geng V, Lurvink H, Pearce I, Vahr Lauridsen S,. Indwelling catheterisation in adults – Urethral and suprapubic. European Association of Urology Nurses; 2024.

2 Australian Government Aged Care Quality and Safety Commission. Strengthened Quality Standards. Available at https://www.agedcarequality.gov.au/providers/quality-standards/strengthened-quality-standards [accessed 20 January 2025]