RESEARCH AIMEvaluate the impact of a

telemonitoring system on urinary continence care for older people living with a

dementia in nursing homes.

SIM® sensor identifiesan event.SIM® sensor and continence aid

worn for 72 hours

Events and observations are recorded on the computerin real time.

Carer attends to the residentand records any interventionvia SIM® assist device.

Carer is notified via handheld SIM® assist device.

REFERENCES Eustice S, Roe B & Paterson J 2009, Prompted voiding for the management of urinary incontinence in adults. Cochrane Collaboration; Cheater F 2006, Systematic review and evaluation of methods of assessing urinary incontinence. Health Technology Assessment 10, 1-132; Offermans MPW, Du Moulin MFMT, Hamers PH, et al. 2009, Prevalence of urinary incontinence and associated risk factors in nursing home residents: a systematic review. Neurourology and Urodynamics 28, 288–294; Ostaszkiewicz J, Chestney T & Roe B 2010, Habit retraining for the management of urinary incontinence in adults. Cochrane Collaboration

ACKNOWLEDGEMENTS Ethical approval from UOW Human Research Ethics Committee. Simavita Pty Ltd. Staff (Karen Carey, Paul Fish and Mark Jaggers), the older people and families who participated, the managers of the nursing home where the research was undertaken and care staff who collected the data.

INTERVENTION • Telemonitoring system installed and training about urinary continence assessment using

the digital system provided

• Telemonitoring system adopted by care staff and data collected and analysed by UOW

• 72 hours of digital monitoring for each older person: Print out used to inform the urinary care plan for each older person

SETTING AND SAMPLE• Australian study (state of Victoria): Nursing home (n=1) for older people living (n=32)

• Frail older people: scoring 4/4 for dependency level with Australian Aged Care Standards Accreditation Agency (100%)

• Living with dementia (100%), 78% women and mean age 81 (±8) years

URINARY CONTINENCE TELEMONITORING SYSTEM

FINDINGSSTATISTICALLY SIGNIFICANT IMPROVEMENTS

1. Severity of episodes of urinary incontinence into continence aids reduced (2,048 to 1,678 mls) (p=≤ 0.015)

2. Frequency of prescribed toileting events decreased (18 to 15) (p=≤ 0.015)

3. Frequency of toilet visits increased (6 to 16) (p=≤ 0.001)

4. Frequency of successful toilet events increased (3 to 8) (p = ≤; 0.011)

5. Compliance with care plans increased (44% to 108%) (p=≤ 0.033)

CONCLUSIONS: IMPLICATIONS FOR PRACTICE• Evidence suggested that the telemonitoring system provided more effective urinary

continence care - Episodes of incontinence reduced (frequency and severity) - Family members less distressed and more confident in continence care provided by care staff - Staff more motivated on improving urinary continence care and became over compliant with toileting care plan

• Future studies need to include healthcare outcome measures

NEW DEVELOPMENTS: DIGITAL RECORDING DEVICES

HYPOTHESISThe new system will identify optimum times for toileting, increase the number of successful toileting events and reduce the volume of urine voided into continence aids.

The Impact of the Introduction of a Telemonitoring System for Urinary Continence Management for Older People Living in a Nursing Home

PING YU, DAVID HAILEY, RICHARD FLEMING, ZHENYU ZHANG AND VICTORIA TRAYNOR A Information Systems and Technology (SISAT) , University of Wollongong, Wollongong, NSW 2522, Australia

T +61 (2) 4221 5412 E ping_yu@uow.edu.au

Observation entry… wherever

Automatic recording of weight

“We’re happier because Dad doesn’t feel like he needs to arrive so early each morning to [the nursing homes] make sure Mum is helped to go to the toilet. He trusts the electronic system.”

“I really believe the system works because now Sara uses the toilet when I take her.”

“Isaac did not have one episode of incontinence for a whole 8 hour period. That’s never happened before.”