Ju Young Yoon; Ji Yun Lee

doi:10.4040/jkan.2010.40.1.110

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Original Article
Development of Outcome Indicators of Urinary Incontinence for Quality Evaluation in Long Term Care Hospitals: Ju Young Yoon, Ji Yun Lee; Journal of Korean Academy of Nursing 2010;40(1):110-118.
DOI: https://doi.org/10.4040/jkan.2010.40.1.110
Published online: February 28, 2010

¹Doctoral Student, School of Nursing, University of Wisconsin-Madison, Madison, WI, USA.

²Full-time Lecturer, Department of Nursing, Hoseo University, Asan, Korea.

Address reprint requests to: Lee, Ji Yun. Department of Nursing, Hoseo University, 165 Sechul-ri, Baebang-myeon, Asan 336-795, Korea. Tel: 82-41-540-9534, Fax: 82-41-540-9558, leejiyun@hoseo.edu

• Received: September 4, 2009 • Accepted: February 4, 2010

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Abstract
NOTES
REFERENCES

Abstract

Purpose
To develop outcome indicators of urinary incontinence to measure quality of care in long term care hospitals in Korea.
Methods
The draft indicators of urinary incontinence were developed from a literature review and clinical expert panel. A survey of medical records of 280 patients in 20 hospitals was conducted to test inter-rater reliability. Statistical analysis was done to test risk adjustment criteria, variation between hospitals, and stability of indicators, using assessment data from 77,918 patients in 623 hospitals.
Results
The inter-rater reliability of items was high (Kappa range: 0.66-0.92). Severe cognitive impairment (odds ratio [OR]: 3.15, confidence interval [CI]: 3.03-3.26) and total mobility activities of daily living (ADLs) dependency (OR: 4.85, CI: 4.72-4.98) increased the prevalence of urinary incontinence, thus they proved to be significant criteria to stratify high and low risk groups. The prevalence for low risk showed more substantial variation than the high risk group. The indicators were stable over one month.
Conclusion
This study demonstrated the feasibility of outcome indicators of urinary incontinence. Improving the reliability of the patient assessment tool and refining the indicators through validation study is a must for future study.
Keywords: Long term care hospital; Urinary incontinence; Quality indicator; Risk adjustment

This research was supported by Health Insurance Review & Assessment Service.

REFERENCES

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Table 1

General characteristics of Organizations and Patients (N=77,918)

ADL=activities of daily living.

Table 2

Draft of Quality Outcome Indicator of Urinary Incontinence

ADL=activities of daily living.

Table 3

Inter-rater reliability of item for Outcome Indicators of Urinary Incontinence

Table 4

Test of Risk Adjustment factors

ADL=activities of daily living; CI=confidence interval.

Table 5

Variance of Quality Indicator value among hospitals and Stability over time

UI=urinary incontinence

Figure & Data

REFERENCES

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Development of Outcome Indicators of Urinary Incontinence for Quality Evaluation in Long Term Care Hospitals

J Korean Acad Nurs. 2010;40(1):110-118. Published online February 28, 2010

DOI: https://doi.org/10.4040/jkan.2010.40.1.110

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Development of Outcome Indicators of Urinary Incontinence for Quality Evaluation in Long Term Care Hospitals

Table 1

General characteristics of Organizations and Patients (N=77,918)

ADL=activities of daily living.

Table 2

Draft of Quality Outcome Indicator of Urinary Incontinence

ADL=activities of daily living.

Table 3

Inter-rater reliability of item for Outcome Indicators of Urinary Incontinence

Table 4

Test of Risk Adjustment factors

ADL=activities of daily living; CI=confidence interval.

Table 5

Variance of Quality Indicator value among hospitals and Stability over time

UI=urinary incontinence

Table 1 General characteristics of Organizations and Patients (N=77,918)

ADL=activities of daily living.

Table 2 Draft of Quality Outcome Indicator of Urinary Incontinence

ADL=activities of daily living.

Table 3 Inter-rater reliability of item for Outcome Indicators of Urinary Incontinence

Table 4 Test of Risk Adjustment factors

ADL=activities of daily living; CI=confidence interval.

Table 5 Variance of Quality Indicator value among hospitals and Stability over time