ORIGINAL ARTICLE Incontinence: prevalence, management, staff knowledge and professional practice environment in rehabilitation units Geraldine McCarthy MSc, MEd, PhD, RNT, RGN Professor of Nursing, Catherine McAuley School of Nursing & Midwifery, National University of Ireland, Cork, Ireland Brendan McCormack BSc (Hons) Nursing, D.Phil (Oxon.), PGCEA, RNT, RGN, RMN Professor of Nursing Research, Institute of Nursing Research/School of Nursing, University of Ulster, Jordanstown, UK Alice Coffey BA, MEd, RNT, RGN College Lecturer, Catherine McAuley School of Nursing & Midwifery, National University of Ireland, Cork, Ireland Jayne Wright PGDip in Advanced Healthcare Practice, RGN Research Associate, Nursing Development Centre, University of Ulster, Royal Hospital, Belfast, UK Paul Slater BSc (Hons), MSc, PhD Research Associate, Institute of Nursing Research/School of Nursing, University of Ulster, Jordanstown, UK Submitted for publication: 16 August 2006 Accepted for publication: 5 December 2008 Correspondence: Geraldine McCarthy Catherine McAuley School of Nursing & Midwifery National University of Ireland Cork Ireland Telephone: +353 21 4901553 E-mail: g.mccarthy@ucc.ie MCCARTHY G., MCCORMACK B., COFFEY A., WRIGHT J. & SLATER P. MCCARTHY G., MCCORMACK B., COFFEY A., WRIGHT J. & SLATER P. (2009) (2009) Incontinence: prevalence, management, staff knowledge and professional practice environment in rehabilitation units. International Journal of Older People Nursing 4, 3–11 doi:10.1111/j.1748-3743.2008.00155.x Background. Bladder and bowel incontinence is a major health care problem, which adversely affects the lives of many individuals living at home or in health service facilities. Current approaches to continence care emphasize comfort, safety and reduction of risk, rather than detailed individualized assessment and management. The literature illustrates a gap between evidence and actual practice and emphasizes the context of care as being a key element for successful implementation of evidence based practice. Aims. To identify prevalence of bowel and bladder incontinence and its manage- ment, investigate continence knowledge and describe the professional practice environment within a rehabilitation unit for older people. Method. An integrated evaluation of continence prevalence, staff knowledge and the work environment was adopted. Results. Findings revealed a high incidence of incontinence (60% urinary, 3% faecal, 37% mixed) a lack of specific continence assessment and specific rationale for treatment decisions or continuation of care. The focus was on continence contain- ment rather than on proactive management. Staff demonstrated a reasonable knowledge of incontinence causation and treatment as measured by the staff knowledge audit. The evaluation of the work environment indicated a low to mod- erate perception of control over practice (2.39), autonomy in practice (2.87), nurse doctor relationship (2.67) and organizational support (2.67). Ó 2009 Blackwell Publishing Ltd 3