Continence interventions can reduce or minimise functional decline and promote social continence and good bladder habits and strategies. Show
In hospital, there are many barriers to maintaining continence and many factors contribute to incontinence. These include:
We are all responsible for helping older people to maintain continence in hospital. This requires an individualised approach at the patient level, but needs to also include policy, systems and environmental design. There are many things we can do to support continence and treat incontinence. Here are some recommendations. Immediately treat any conditions that are causing the person’s incontinence, for example:
Urge incontinence Consider:
Stress incontinence
Nocturia If the person is getting up to go to the toilet more than twice a night:
Dementia If the person has dementia, consider:
Faecal incontinence If the person's stool is too hard, consider:
If the person’s stool is too soft, consider:
Modify the environmentThe environment can make it difficult for a person to access the toilet. Modify the environment so the person can toilet independently and to minimise the risk of falls.
Develop a continence management planAn individualised continence management plan should be developed and implemented in conjunction with the older person. It should be regularly reviewed and adjusted as needed. The plan should be based on information provided by the patient, their family or carer, and their residential care facility if they are not living at home. The plan should be comprehensive and include the following elements. A toileting plan
Educate the patient and their carers
Refer to other health professionalsRefer the person to:
Practise person-centred carePerson-centred practice and clear documentation are the keys to managing continence issues. It is important to respect the dignity and privacy of the older person and to involve them in every aspect of care. Communicating the care plan with the rest of the healthcare team, including the patient and family or carer, is also vital in providing a consistent person-centred approach to continence management. 1. Society of Hospital Medicine. Five Things Physicians and Patients Should Question. 2013 [cited 2015 March 26]; Available from: http://www.choosingwisely.org/doctor-patient-lists/society-of-hospital-medicine-adult-hospital-medicine/. 2. Kim, S., S. Liu, and V. Tse, Management of urinary incontinence in adults. Australian Prescriber, 2014. 37(1): p. 10-3. 3. Continence Foundation of Australia, The Continence Guide - Bladder and Bowel Control Explained, 2014, The Continence Foundation of Australia: Melbourne. 4. Deakin University/Eastern Health, A continence resource guide for acute and subacute settings, 2008, Melbourne: Deakin University/Eastern Health. 5. Deakin University/Eastern Health, Assessing urinary incontinence and related bladder symptoms educational resource, 2008, Eastern Health: Melbourne. What are nursing interventions for someone with urinary incontinence?Nursing Interventions
Promote access to toilet facilities, and instruct patient to make scheduled trips to the bathroom. Scheduled voiding allows for frequent bladder emptying. Give or encourage the use of medications as ordered: Anticholinergics.
What interventions can be done to help patients with incontinence provide four 4 examples interventions?Options may include:. increased fluid intake of up to two litres a day.. high-fibre diet.. pelvic floor exercises.. bladder training.. training in good toilet habits.. medications, such as a short-term course of laxatives to treat constipation.. aids such as incontinence pads.. How would you manage a patient with urinary incontinence?Behavioral techniques. Bladder training, to delay urination after you get the urge to go. ... . Double voiding, to help you learn to empty your bladder more completely to avoid overflow incontinence. ... . Scheduled toilet trips, to urinate every two to four hours rather than waiting for the need to go.. What is the best intervention for urge incontinence?The best treatment for urge incontinence is behavior therapy in the form of pelvic floor muscle exercises. Medications, used as an adjunct to behavior therapy, can provide additional benefit.
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