Onset PrevenTIon of Urinary Retention in Orthopaedic Nursing and Rehabilitation (OPTION)

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

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.

Study Overview

• Status: Active, not recruiting
• Conditions: Hip Fractures; Urinary Retention; Hip Arthritis
• Intervention / Treatment: Other: : A support program to facilitate implementation of evidence-based practice for postoperative urinary retention

• Study Type: Interventional
• Enrollment (Estimated): 20
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Sweden
  • Arvika, Sweden
    • Sjukhuset Arvika
  • Danderyd, Sweden
    • Danderyds Sjukhus
  • Eksjö, Sweden
    • Höglandssjukhuset Eksjö
  • Enköping, Sweden
    • Enköpings lasarett
  • Eskilstuna, Sweden
    • Mälarsjukhuset
  • Huddinge, Sweden
    • Karolinska University Hospital, Huddinge
  • Johanneshov, Sweden
    • Capio Ortopediska Huset
  • Karlskoga, Sweden
    • Karlskoga Lasarett
  • Motala, Sweden
    • Capio Specialistvård Motala
  • Norrköping, Sweden
    • Vrinnevisjukhuset
  • Norrtälje, Sweden
    • Norrtälje Sjukhus
  • Nyköping, Sweden
    • Nyköpings lasarett
  • Stockholm, Sweden
    • Södersjukhuset
  • Södertälje, Sweden
    • Södertälje Sjukhus
  • Torsby, Sweden
    • Sjukhuset Torsby
  • Västerås, Sweden
    • Västmanlands sjukhus
  • Örebro, Sweden
    • Orebro University Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria: Orthopaedic units in Sweden performing hip surgery. -

Exclusion Criteria: Orthopaedic units in Sweden not performing hip surgery

-

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: A support program to facilitate implementation of EBP for postoperative urinary retention; 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; A 12-month implementation support program for multi-professional internal facilitator teams
No Intervention: Control-No support program; 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

Collaborators and Investigators

• Sponsor: Örebro University, Sweden
• Collaborators: Karolinska Institutet; Linkoeping University
• Investigators: Principal Investigator: Maria Hälleberg Nyman, PHD, Örebro University, Sweden

Publications and helpful links

General Publications

• Eldh AC, Joelsson-Alm E, Wretenberg P, Halleberg-Nyman M. Onset PrevenTIon of urinary retention in Orthopaedic Nursing and rehabilitation, OPTION-a study protocol for a randomised trial by a multi-professional facilitator team and their first-line managers' implementation strategy. Implement Sci. 2021 Jun 26;16(1):65. doi: 10.1186/s13012-021-01135-x.

Study record dates

Study Major Dates

• Study Start (Actual): December 15, 2020
• Primary Completion (Estimated): December 30, 2025
• Study Completion (Estimated): May 30, 2027

Study Registration Dates

• First Submitted: December 23, 2020
• First Submitted That Met QC Criteria: January 7, 2021
• First Posted (Actual): January 8, 2021

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: March 18, 2025
• Last Verified: March 1, 2025

More Information

Terms related to this study

• Keywords: Implementation; Orthopedics; Research utilization
• Additional Relevant MeSH Terms: Urogenital Diseases; Wounds and Injuries; Male Urogenital Diseases; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urination Disorders; Leg Injuries; Fractures, Bone; Femoral Fractures; Hip Injuries; Hip Fractures; Urinary Retention
• Other Study ID Numbers: ORU 2020/03330

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No