How is the quality of continence care determined in Australian residential aged care settings?: A content analysis of accreditation reports

Few research papers have been published about the quality of continence care residents of aged care facilities receive or the evaluative criteria assessors use to determine a facility’s performance against continence care standards. The objectives of the study were to identify the descriptors used to report the quality of continence care in accreditation reports and compare these descriptors with a list of international recommendations. Ten per cent of accreditation reports in one Australian state were reviewed and analysed to establish the frequency of descriptors used by assessors when reporting the quality of continence care. Each identified factor was then compared against international recommendations for managing incontinence in frail, older adults. Eighteen descriptors were identified, but only three were congruent with international recommendations. They were: the frequency of incontinence, residents’ personal care goals and treatment preferences, and environmental factors. Reports lacked information about the quality and outcomes of continence assessments, what constituted resident/representative satisfaction, and a "system" or "process". As accreditation reports lacked information about care processes for actively diagnosing and managing residents’ continence care needs, it may be useful for assessors to use a checklist of continence care recommendations based on international guidelines.