title: Can district nurses and care home staff improve bowel care for older people using a clinical benchmarking tool?
abstract: A quasi-experimental study tested a clinical benchmarking tool (Essence of Care) to improve bowel-related care for older people living in six care homes. In the intervention care homes, district nurses and care home staff used the clinical benchmarking tool to discuss and plan how to improve bowel care for residents. In the control care homes, staff were provided with detailed information about the residents and continence services contact details. The intervention was acceptable to care home and district nursing staff, and possible to incorporate into existing working patterns. The study did not demonstrate a significant reduction in bowel-related problems, although there was evidence in one care home of reduction in episodes of avoidable faecal incontinence. At an individual level of care, there were observable benefits, and examples of person-centred care were prompted through participating in the intervention and improved staff awareness. Clinical benchmarking tools can be used to structure discussion between district nurses and care home staff to review and plan care for residents. However, it takes time to achieve change and embedding this kind of approach requires either robust pre-existing working relationships or the involvement of a facilitator.
authors: Professor of Health Care Research, Centre for Research in Primary and Community Care, University of Hertfordshire.
authors: Claire
authors: C
authors: Goodman
authors: Research Fellow, Centre for Research in Primary and Community Care, University of Hertfordshire.
authors: Sue
authors: S
authors: L Davies
authors: Professor of Nursing, Kings College London.
authors: Christine
authors: C
authors: Norton
authors: Professor of Continence Technology/Associate Dean, University of Southampton.
authors: Mandy
authors: M
authors: Fader
authors: Honorary Research Associate Primary Care & Population Health, Royal Free Campus, University College London School of Life and Medical Sciences.
authors: Jackie
authors: J
authors: Morris
authors: Postgraduate Student, Department of Psychology, University of Exeter.
authors: Mandy
authors: M
authors: Wells
authors: Professor of Health Economics, University of Surrey.
authors: Heather
authors: H
authors: Gage
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019985:Benchmarking; D003152:Community Health Nursing; D003248:Constipation / Q000451:nursing*; D005242:Fecal Incontinence / Q000451:nursing*; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D008370:Manuals as Topic; D008875:Middle Aged; D009735:Nursing Homes; D009936:Organizational Innovation; D017749:Total Quality Management / Q000379:methods*; D006113:United Kingdom