Development of clinical practice guidelines for urinary continence care of adult stroke survivors in acute and rehabilitation settings.
Bibliographic record
Abstract
This study developed evidence-based clinical practice guidelines for the urinary continence care of adult stroke survivors in acute and rehabilitation settings. The research team conducted a comprehensive review of the literature on urinary continence interventions and outcomes. The team then developed a set of recommendations outlined in the resulting clinical practice guidelines titled Clinical Practice Guidelines (CPGs) for the Urinary Continence Care of Stroke Survivors in Acute and Rehabilitation Settings. The evaluation of the CPGs consisted of a two-part assessment and pilot implementation. An expert panel of 25 local and regional experts in stroke and continence care assessed the proposed CPGs. This assessment consisted of two stages: a) evaluating the guidelines using the Appraisal of Guidelines Research and Evaluation (AGREE) Instrument (http://www. agreetrust.org); and, b) conducting focus groups to identify barriers and facilitators to the implementation of the guidelines using the Ottawa Model of Research Use (OMRU). Results from the expert panel assessments/feedback contributed to the refinement of the CPGs as well as identification and construction of implementation strategies. Two sites conducted a three-month pilot implementation of three recommendations from the CPGs as selected by each site. The two inpatient sites were a rehabilitation setting and a mixed acute and rehabilitation setting. The implementation of the CPGs included the development of learning strategies tailored to the needs of each site and in addition to the creation of an online self-learning portal. This study assessed nurses' knowledge, attitudes, and beliefs regarding urinary continence challenges using a survey before and after the pilot. Chart reviews before and after the pilot implementation audited the nurses' urinary continence practices for patients and uptake of the selected guidelines' recommendations. Study findings suggested the implementation of the CPGs' recommendations improved nurses knowledge of the continence needs of stroke survivors.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.110 | 0.235 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.008 | 0.006 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.006 | 0.005 |
| Open science | 0.007 | 0.007 |
| Research integrity | 0.007 | 0.009 |
| Insufficient payload (model declined to judge) | 0.004 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".