Transcript Continence - HCA FEB 2015

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.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Support people with the same respect you would want for yourself
or a member of your family
Treat each person as an individual by offering a personalised
service
Enable people to maintain the maximum possible level of
independence, choice and control
Listen and support people to express their needs and wants
Respect people’s right to privacy
Ensure people feel able to complain without fear of retribution
Have a zero tolerance of all forms of abuse
Engage with family members and carers as care partners
Assist people to maintain confidence and a positive selfesteem
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 compassion
A – assist with toileting, ensuring dignity
R – relieve pain effectively
E – encourage adequate nutrition
Q3. Have you had the help you needed getting to the toilet?
100
95
2
4
9
7
4
3
8
11
90
3
5
10
3
2
10
10
10
5
10
Percentage
85
80
No
Yes sometimes
75
Yes always
70
89
90
88
86
88
85
87
87
Oct-13
Nov-13
Target
85
65
60
55
50
Apr-13
May-13
Jun-13
Jul-13
Aug-13
Sep-13
Dec-13
Q4. Have you been treated with respect and dignity?
100
3
3
1
2
5
5
6
3
1
5
6
95
90
Percentage
85
80
No
Yes sometimes
75
96
97
97
95
95
94
97
94
94
70
Yes always
Target
65
60
55
50
Apr-13
May-13
Jun-13
Jul-13
Aug-13
Sep-13
Oct-13
Nov-13
Dec-13
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
New
fixation
device
‘PreConnect’,
stays
connected
for 14 days
(not 7)
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’ plans
o Bottle Holders
o CAUTI – Catheter Associated Urinary Tract
Infections
o Catheters
o ?Over used in RHCT
o Promote ‘flip-flow’ valves
o Remove ASAP
o DATIX
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