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Table 1 Key quality indicators used to assess fidelity to treatment delivery as recorded on the clinical logs

From: Assessing fidelity to treatment delivery in the ICONS (Identifying Continence OptioNs after Stroke) cluster randomised feasibility trial

Stage Key quality indicator Definitions of components
1. VOIDING INTERVALa: The voiding interval is the specified length of time between each void for the patient for that day. The voiding interval determines the frequency of voiding throughout the day.
Is the voiding interval present and appropriately documented? Appropriate documentation refers to the documentation of an individual number (such as “2-hourly”) and not a range (such as “2 – 3 hourly”).
2. PROPOSED VOIDING TIMESa: Proposed voiding times should be documented at the start of each day, based upon the voiding interval. The proposed voiding times form a schedule of times for toileting, which healthcare staff should then try to follow.
Are proposed voiding times present and documented correctly? Proposed voiding times ‘present’: There should be no missing entries between the first and last documented proposed voiding time.
Proposed voiding times ‘documented correctly’: Each interval between consecutive proposed voiding times should be identical to the voiding interval (e.g. 2 h between consecutive proposed voiding times for a voiding interval of “2-hourly”).
3. ACTUAL VOIDING TIMES – within schedule: The actual voiding times are the times at which the patient was toileted, and are recorded by healthcare staff.
For how many proposed voiding times is the ‘actual voiding time’ documented and within 30 min? The ‘gold standard’ for the ICONS intervention is that an actual voiding time should be within 30 min of a proposed voiding time.
4. (a) GOOD PRACTICE – Encouragement: For how many proposed voiding times is the answer “YES” documented in response to the question “Did you give encouragement?” For each voiding occasion, healthcare staff are required to indicate on the clinical log whether they have undertaken a number of ‘best practice’ components of the regime. These include giving encouragement to the patient and asking them whether they are wet (if on prompted voiding regime).
4. (b) GOOD PRACTICE – Asking the patient if they are wetb:
For how many proposed voiding times is the answer “YES” documented in response to the question “Did you ask the patient if they were wet?”
  1. aA clinical log was not examined further if it did not achieve this stage
  2. bThis criterion refers to prompted voiding clinical logs only