This study presents the introduction of a comprehensive trial of void (TOV) guideline in the gynaecology department of a large tertiary hospital in Queensland, Australia. The aim was to standardise care and increase both nursing and medical staff compliance and satisfaction of processes in the department while improving quality of care. This was measured by a two-phased (pre- and post-implementation) survey of gynaecology department staff. The survey evaluated knowledge, confidence, compliance and satisfaction when comparing the previous TOV local protocol to a new standardised guideline introduced during the study. As follow-up, an audit of medical records was also conducted to reflect clinical practice. The TOV guideline was adopted following consultation and benchmarking with other Australian tertiary hospitals and implemented with a 3-month education program. Pre-implementation survey responses (n=51) from medical and nursing staff with wide range of gynaecology experience (35% 0–2 years, 65% >3 years) were compared with post-implementation survey responses (n=45). Staff knowledge of TOV process increased from the pre-implementation survey (71%) to post-implementation (84%). The overall improvement in satisfaction of the new guideline increased from 37% to 82%. Compliance in using the new guideline was 80% compared to 73% for the previous local protocol. Over a 4-month period for both audits, the pre-implementation audit (n=48) resulted in 33% compliance compared to the post-implementation audit (n=36), 86% compliance. The study determined that the introduction of a standardised TOV guideline improved knowledge, compliance and satisfaction when performing a TOV within the gynaecology department.

Incontinence-associated dermatitis (IAD) is a common complication often unrecognised and mistreated in individuals with incontinence. It is the erosion of the skin from prolonged exposure to urine and/or faeces from incontinence and is often mistaken for a pressure injury. People experience considerable discomfort such as pain, burning and itching in the affected areas (buttocks, perineum and gluteal clefts). The prevention and management of IAD involves assessing and managing incontinence and implementing a skin care regimen to protect and maintain the integrity of the person’s skin. We report a case study of a 71-year-old female to illustrate the benefits of an interdisciplinary plan of care for IAD to prevent further complications. The woman at the centre of our case study had multiple co-morbidities and severe urinary stress incontinence prior to her admission. A multidisciplinary team – continence nurse practitioner (NP), wound clinical nurse consultant (CNC), occupational therapist (OT) – were engaged to devise a management plan to manage her incontinence, treat the IAD and improve skin integrity. The purpose of this case study is to present their treatment journey through a regional health service, the issues encountered, and the prevention and management plans implemented in order to highlight best practices and the benefits of an interdisciplinary plan of care.