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Health Serv Res. 1990 October; 25(4): 627–637.
PMCID: PMC1065649

Statistical quality control in nursing homes: assessment and management of chronic urinary incontinence.


This article describes a statistical quality control system that allows nurse managers to monitor staff performance of a critical patient care function. Descriptive data concerning patients' incontinence frequencies were collected during a two-day assessment period for 87 patients under conditions that guaranteed that the patients' protective garments were changed on a one- or two-hour basis. The average and expected norms of patient wetness were calculated for a sample of patients in four different nursing homes. Periodic monitoring of patient wetness in each sample and the use of statistical quality control charts permitted nurse managers to determine if nursing aides were changing patients on either a one- or a two-hour schedule. The implications of the research for meeting federal incontinence care standards and for assuring high-quality patient care are discussed.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Brown M. Nursing assistants' behavior toward the institutionalized elderly. QRB Qual Rev Bull. 1988 Jan;14(1):15–17. [PubMed]
  • Hu TW, Igou JF, Kaltreider DL, Yu LC, Rohner TJ, Dennis PJ, Craighead WE, Hadley EC, Ory MG. A clinical trial of a behavioral therapy to reduce urinary incontinence in nursing homes. Outcome and implications. JAMA. 1989 May 12;261(18):2656–2662. [PubMed]
  • Nyman JA. Excess demand, consumer rationality, and the quality of care in regulated nursing homes. Health Serv Res. 1989 Apr;24(1):105–127. [PMC free article] [PubMed]
  • Ouslander JG, Kane RL. The costs of urinary incontinence in nursing homes. Med Care. 1984 Jan;22(1):69–79. [PubMed]
  • Schnelle JF, Sowell VA, Hu TW, Traughber B. Reduction of urinary incontinence in nursing homes: does it reduce or increase costs? J Am Geriatr Soc. 1988 Jan;36(1):34–39. [PubMed]
  • Schnelle JF, Traughber B, Sowell VA, Newman DR, Petrilli CO, Ory M. Prompted voiding treatment of urinary incontinence in nursing home patients. A behavior management approach for nursing home staff. J Am Geriatr Soc. 1989 Nov;37(11):1051–1057. [PubMed]

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