Distance coursework and coaching to improve nursing home incontinence care: lessons learned.

OBJECTIVES To determine whether a distance coaching course on improving nursing home incontinence care could be replicated and brought to scale with a larger group of nursing homes without sacrificing outcomes. DESIGN The study collected descriptive and comparative data. SETTING Fourteen nursing homes in the original course and 34 in the replication course. PARTICIPANTS Participants in the study were supervisors and staff from enrolled nursing homes who completed the distance coaching courses on incontinence management. MEASUREMENTS Data for both courses were collected using a resident assessment form to evaluate implementation of new practices, pre- and posttraining quizzes, a course evaluation survey, and a supervisor's report. RESULTS There were few significant differences between the course groups with respect to course participation, knowledge transfer, and training program preferences. Although Course 1 nursing homes reported assessing more residents on average than Course 2 homes (22 vs 12), this difference is probably an artifact of differences in the reporting methodologies for the two courses. CONCLUSION This study found qualified support for using a distance coaching course to facilitate adoption of evidence-based incontinence care practices in nursing homes. The findings also underscore the challenges associated with designing dissemination and implementation programs that are effective and feasible to implement with nursing homes. Nursing home educators should consider this study's findings when designing new training programs. Outcomes may improve if some dissemination resources are diverted to distance coaching activities that support nursing home improvement efforts over extended periods.