• Maria Hälleberg Nyman, Henrietta Forsman, Lars Wallin, Joan Ostaszkiewicz, Ami Hommel, and Ann Catrine Eldh.
• School of Health Sciences, Örebro University, Örebro, Sweden.
• J Eval Clin Pract. 2019 Apr 1; 25 (2): 282-289.

Rationale, Aims, And ObjectivesThe risk of developing urinary incontinence (UI) is associated with older age and hip surgery. There has been limited focus on factors that promote evidence-based UI practice in the orthopaedic context. The aim of this study was to evaluate an implementation intervention to support evidence-based practice for UI in patients aged 65 or older undergoing hip surgery.MethodsA 3-month intervention was delivered in 2014 to facilitate the implementation of UI knowledge in orthopaedic units in 2 hospitals in Sweden. Each unit appointed a multidisciplinary team of nurses and physiotherapists or occupational therapists to facilitate the implementation. The teams were supported by external facilitators who shared knowledge about UI and implementation science. Interviews, nonparticipant observations, and audits of patient records were performed.ResultsPrior to the intervention, there was no use of guidelines regarding UI. The intervention raised the internal facilitators' awareness of UI risks associated with hip surgery. As internal facilitators shared this information with their peers, staff awareness of UI increased. The teams of internal facilitators described needing additional time and support from managers to implement evidence-based UI care. A management initiative triggered by the intervention increased the documentation of UI and urinary problems in 1 unit.ConclusionTo promote evidence-based practice related to safe procedures for older people in hospital care, there is a need to better understand strategies that successfully facilitate knowledge implementation. This study suggests that a multiprofessional team approach is promising for instigating a process towards evidence-based management of UI.© 2018 John Wiley & Sons, Ltd.

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