Onset PrevenTIon of Urinary Retention in Orthopaedic Nursing and Rehabilitation

Study Overview
=================
Brief Summary
-----------------
Urinary retention (UR) is a common problem in older people undergoing hip surgery. Untreated UR can lead to bladder distention and a permanent damage of the bladder, which can cause both physical and psychical suffering as well as increased costs for society. Even if national and international practice guidelines are in place for handling UR within the health care system, many fail to comply with them. Compliance to clinical practice guidelines are improved if different professions and managers collaborate as a team. In OPTION (Onset PrevenTIon of urinary retention in Orthopedic Nursing and rehabilitation) the investigators will coach multi-professional local facilitator teams in knowledge translation and implementation of UR practice as well as investigate the effects of such evidence-based practice in orthopedic nursing and rehabilitation. Implementation of research-based knowledge in evidence-based practice within an organization is complex with several known interacting factors. In a health care system these factors can be the care context, knowledge (innovation) and how the organization facilitates such implementations. The implementation strategy of OPTION utilize established theories of facilitation of knowledge implementation considering evidence and context with focus on leadership. The intervention consists of seminars and systematic support for implementation of UR-guidelines OPTION combine studies of adherence to evidence based practice regarding UR for patients over 65 years old that has undergone hip surgery and the health economic aspects of it. OPTION also contribute with improvements and increased knowledge regarding strategies to implement evidence based health care that can be used in other areas than UR and hip surgeries.

Official Title
-----------------
Onset PrevenTIon of Urinary Retention in Orthopaedic Nursing and Rehabilitation, OPTION - a Knowledge Implementation Study on a Facilitation Strategy for Multi-professional Clinical Champion Teams

Conditions
-----------------
Urinary Retention, Hip Fractures, Hip Arthritis

Intervention / Treatment
-----------------
* Other: : A support program to facilitate implementation of evidence-based practice for postoperative urinary retention


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Orthopaedic units in Sweden performing hip surgery. - Exclusion Criteria: Orthopaedic units in Sweden not performing hip surgery -

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: A support program to facilitate implementation of EBP for postoperative urinary retention<br>12- month support program. Multi-professional facilitator-teams will be supported by a 12-month support program including seminars and monthly supervision (e-discussion forum and group teleconferences) to develop an awareness of, and skills in facilitating implementation of evidence/EBP in clinical everyday care. | Other: : A support program to facilitate implementation of evidence-based practice for postoperative urinary retention<br>* A 12-month implementation support program for multi-professional internal facilitator teams<br>|
| No Intervention: Control-No support program<br>No support program | |

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Adherence to UR guidelines in the care of patients undergoing hip surgery. | Adherence to national urinary retention guidelines documented in the patients' medical record | Change from base line to 1 year after the intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of hip surgery patients with UR | Number of hip surgery patients with UR documented in the patients' medical record | Change from base line to 1 year after the intervention | 
| Patient participation | The Patient Preferences for Patient Participation tool (The 4Ps) | Change from base line to 1 year after the intervention | 
| Costs related to UR | Costs for device and labour for bladder scanning and urinary catheterization | Change from base line to 1 year after the intervention | 
| The IFs', staff's, and managers' experience of UR care | Investigated with qualitative interviews | Change from base line to 1 year after the intervention | 
| The IFs', staff's, and managers' experience of the facilitation program | Investigated with qualitative interviews | 1 year after the intervention | 
| The experience of people undergoing hip surgery, regarding UR, UR care. | Investigated with qualitative interviews | Change from base line to 1 year after the intervention | 
| The impact of a knowledge translation support program on the peoples' experience of the above | Investigated with qualitative interviews | Change from base line to 1 year after the intervention | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Orthopedics, Implementation, Research utilization