continence. aims of the session… to bring you up-to-date with current best practice in continence...
TRANSCRIPT
Continence
Aims of the session…
• To bring you up-to-date with current best practice in continence assessment management
• To give you practical advise and information you can go back and use today in your clinical area
• To reinforce recommendations coming from the RCHT Continence Action Group
The Impact of Incontinence
14 million people in the UK are affected by some sort of bladder problem
It's estimated that 6.5m people in the UK have some kind of bowel control problem
Women are more likely to be affected by bladder control problems than men
Incontinence in most prevalent in the elderly
Urinary incontinence can be treated successful in a great
many cases
‘The Dignity Challenge’High quality services that respect people’s dignity should:
1. Support people with the same respect you would want for yourself or a member of your family
2. Treat each person as an individual by offering a personalised service
3. Enable people to maintain the maximum possible level of independence, choice and control
4. Listen and support people to express their needs and wants5. Respect people’s right to privacy6. Ensure people feel able to complain without fear of retribution7. Have a zero tolerance of all forms of abuse8. Engage with family members and carers as care partners9. Assist people to maintain confidence and a positive self-
esteem10. Act to alleviate people’s loneliness and isolation
http://www.scie.org.uk/publications/guides/guide15/standupfordignity/dignitychallenge/index.asp
2: Treat each person as an individual by offering a personalised service
• Assessment is fundamental to know the individual and their needs
• One size does not fit all!!
5: Respect people’s right to privacy
• Clean toilets • Well signposted
doors that close• Assess toilet needs
give choice• ‘Toilet’ should be the
default first option• Response promptly• ‘Pro-active’ toileting
The Patient Association: The Care Challenge
C – communicate with compassionA – assist with toileting, ensuring dignityR – relieve pain effectivelyE – encourage adequate nutrition
Apr-13 May-13 Jun-13 Jul-13 Aug-13 Sep-13 Oct-13 Nov-13 Dec-1350
55
60
65
70
75
80
85
90
95
100
89 90 88 86 8885 87 87 85
9 78 11
10
1010 10
10
2 4 4 3 35 3 2 5
Q3. Have you had the help you needed getting to the toilet?
NoYes sometimesYes alwaysTarget
Pe
rce
nta
ge
Apr-13 May-13 Jun-13 Jul-13 Aug-13 Sep-13 Oct-13 Nov-13 Dec-1350
55
60
65
70
75
80
85
90
95
100
96 97 97 95 95 9497
94 94
3 3 2 5 5 6 3 5 61 1
Q4. Have you been treated with respect and dignity?
NoYes sometimesYes alwaysTarget
Pe
rce
nta
ge
9: Assist people to maintain confidence and a positive self esteem
• Confidence is based in knowledge and understanding
• Confidence grows when solutions are found and hope emerges
Reversible Factors of Incontinence. The Continence Risk Assessment
An evidence based screening tool that enquires into seven reversible factors which commonly cause incontinence
Developed to simply guide best practice in the initial assessment of new incontinence symptoms
Let’s try and name the seven reversible
factors??
“7 Reversible Factors”
• Fluid intake• Urinary tract infections• Functional causes • Medications and drugs• Atrophic vaginitis / urethritis• Uncontrolled / undiagnosed diabetes• Constipation
Fluid Intake
Urinary Tract Infections
Functional causes
Atrophic vaginitis
Medication and drugs
Uncontrolled / undiagnosed diabetes
Constipation
‘Pre-Connect’, stays connected for 14 days (not 7)
New fixation device
Transferring classroom learning back to the clinical area…
What can you take back into practice from what we have shared today?
What I hope to have covered…
o ‘Pad and Pant’ planso Bottle Holderso CAUTI – Catheter Associated Urinary Tract
Infectionso Catheters
o?Over used in RHCToPromote ‘flip-flow’ valvesoRemove ASAPoDATIX
o Future ‘Talking Tool Kit’ on continence management
Documentation
• CHA 2930 - Urinary Incontinence Assessment and Management Care Plan
• CHA 2931 - Faecal Incontinence Assessment and Management Care Plan
both are used in conjunction with the Incontinence Screening Tool (now in Risk Assessment Pack)
• CHA 2725 Catheter insertion record and care plan