how we help patients psychologically through preparation techniques in a urology department
DESCRIPTION
How we help patients psychologically through preparation Techniques in a Urology department. Presented by Yvie Morley – Health Play Specialist (Nephro-Urology) & Cheryl Jennings Urology Nurse specialist. Royal Manchester Children’s Hospital. Meet the Nursing Team. - PowerPoint PPT PresentationTRANSCRIPT
How we help patients psychologically through preparation Techniques in a
Urology department.
Presented by
Yvie Morley – Health Play Specialist (Nephro-Urology)
&
Cheryl Jennings Urology Nurse specialist.
Royal Manchester Children’s Hospital
Sue Wright – Urology nurse specialist
Janet Fishwick – head of urology
specialist nursing
Cheryl Jennings - Urology Nurse
Specialist
Bev Whitnall – Urology Nurse Specialist
Meet the Nursing Team
• Bladder Augmentation• Mittrofanoff.• Removal catheters.• Bowel Management.• Urodynamics.• Bladder Neck repair.• Formation of urostomy• Bladder extrophy transition
clinic.• Bladder washouts.• Bladder Assessments.• Intermittent self
catheterisation.
Urology Preparation
Challenges
What catheterisation involves
•Distressing for child
•Invasive procedure
•Reluctance to comply
•Not short term, life long
Intermittent self catheterisation
Preparation for catheterisation.
•Magazine
•Story books/ comic book
•Step by step cards
•Catheter Ted
•DVD
•Mirror
•Catheter Play
•Catheterisation Diaries
• Lots of upset children• Needed to slow the process down• Make the child feel involved in the process• Consider their feelings and thoughts• Give them hints, tips and encouragement.• Simple pictures • Step by step approach.• Gain the child’s trust
Catheterisation Diaries
Catheterisation Diary
Gets the child talking about their feelings towards the procedure without feeling interrogated!
Distressed child
Joint Home visits
Play with catheterse.g. bath time.
Locating urethraUsing a mirror.
Fully insert catheter.Insert tip of catheterInsert up to bladder
neck
Complete diary For thought and
feelings
Placing catheterAround urethral
Opening.
A psychological approach
• Nurse led clinic• Full bladder assessment• Advice on fluid intake/diet• Intensive bladder training
programme• Simple explanation on how
the urinary system should work.
• Support for child and family.• Referral for urodynamics.• Work book to complete.
Bladder Assessment Clinic
• Lots of information given here and there.• Nothing that was aimed directly at the child.• Nothing that really engaged the child in the assessment.• Long and not child friendly charts to fill in.• Information that wasn’t needed.• Simple clear information that both child and family can follow.• A section for extra information/help/support• An incentive for the child to complete the programme for 2 weeks.
Why have a work book ?
Original bladder Diary
Simple picture of the urinary system
Brief explanation about section
What’s in the book ?
5-10 years reminder how to train your bladder.
10 years + how to train your bladder.
Draw on how many drinks you had today. What drinks are good /bad for the bladder.
The good fibre guide.
Poo diary!
The wetting Diary
Simple Key for the child to follow when filling in diary.
A5 School Diary
Easier to keep in bag at school attach it to main diary before clinic review.
The incentive to complete the programme.
Just a bit of fun
Sarah’s Diary
It’s really annoying me!
Children engage with the programme
Abigail’s comments
Parents engage with the programme and work together with their child.
The Results
• All the children engage with the programme.
• Children want to continue with sheets after initial 2 week assessment.
• Children are dry.
• Decreases amount of review clinics.
• Increases discharge rate from service.
• Children feel involved in their treatment.
• Improves self esteem and well being.
Thank you for listening