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.