Incontinence Diseases: A Case Study

Difficulties with continence can affect an individual’s self-esteem, health and their day to day activities. Incontinence sufferers have been known to lose self-esteem and confidence and even withdraw from their usual circle of friends and family. The fear of being found out can make an individual feel ashamed of their condition. These feelings as a whole can impact negatively on an individual’s life. If the incontinence is due to a urinary infection, this could cause intimacy issues, leading to fear of rejection from a spouse. Family outings or sports activities may be affected due to fear of

This reflection case study will be discussing urinary continence management using Gibbs reflective framework (Gibbs,1988). This will include what is urinary incontinence management, the pathophysiology of urinary incontinence after stroke, how continence affect patient and current clinical practice and the role of the nurse and multi-disciplinary team within continence management. Also using the evidence based research and national guidelines.

Incontinence is one of the major problems faced by the elderly. Nurses can play a significant role in discovering continence problems (Lea R.et.al.2007). Urinary incontinence is the unintentional passing of urine. It is a very common problem and is thought to affect more than 50 million people in the developed world.(NHS.UK). To identify the problem and provide necessary treatment at the early stage, a thorough physical assessment is necessary.

Incontinence can affect individuals mentally as well as physically, it can have a negative effect

Urinary incontinence is very common following a stroke with 40-60% of hospitalised patients experiencing it in the acute phase, 25% on discharge and one third of survivors experiencing ongoing problems at one year (Barrett 2002, Kolominsky-Rabas et al.2003).Bladder and bowel problems are common following a stroke and can have a huge impact on physical and psychological aspects of quality of life, for both patients and carers. Health care professionals can do much to help improve and manage incontinence problems in stroke patients and this starts with a good understanding of key issues. Mobility and manual dexterity problems can compound bladder and bowel symptoms because they can make toileting access difficult, other problems such as visual disturbances, dysphagia and cognition also contribute indirectly to continence difficulties. There is evidence that professional input through structured assessment and management of care, together with the involvement of specialist continence nursing services, may reduce urinary incontinence and related symptoms after stroke. Bladder and bowel care requires active management –this includes a written personalised plan, taking into consideration required assistance, personal needs and goals. This essay is an overview on the importance of timely nursing assessment and management of urinary incontinence

The first step nurses can take to decrease the incidents of CAUTIs in older adults is avoiding unnecessary use of catheters altogether. Initially, this begins with nurses knowing both appropriate and inappropriate situations in which a catheter should be utilized. According to (Gould et al., 2017), an appropriate situation is one where a patient has acute urinary retention or bladder obstruction, whereas an inappropriate situation is one where a catheter is being used a means of obtaining urine for culture when the patient can voluntarily void. Nurses can also use basic techniques like palpation, percussion, and inspection to effectively assess urinary retention, which is the main reason for catheterization as mentioned earlier. When techniques like this do not achieve desired results,

In this Assessment nursing course, one of the major things that is taught is the most important part of giving proper care to a patient. Correct patient assessment is needed before any nursing care plan or treatment can be implemented. This post-review of a person’s assessment will demonstrate the proper way to go about assessing a person’s health.

2011). Incontinence is defined as the complaint of any involuntary loss of urine (urine incontinence) or faecal material (faecal incontinence) or both (double incontinence) (Abrams et al. 2009). Incontinence is a widespread problem in all healthcare settings (Du Moulin et al. 2008; Macmillan et al. 2004). Figures produced by Macmillan et al. (2004) studies on the prevalence of incontinence varied but prevalence was estimated between 10% and 15% for faecal incontinence measured in community-dwelling adults and up to 46% for urinary incontinence measured in older, home-care patients in Du Moulin et al. (2008) studies results. This shows that there is a huge amount of patients at risk for IAD due to them having the risk factor of incontinence. Therefore the prevention of IAD should be paramount in the care of any patients or clients who are at risk for

The patient and their families must be aware of the infection, the source of infection, signs and symptoms, treatments, and measures to apply at home to decrease their risk of receiving an infection. Because geriatric patients are incontinent they may need a catheter in place to help remove their urine. Nurses must perform aseptic technique, wearing proper gloves when inserting or removing device. Another way to help reduce the risk of elderly urinary tract infections would be to avoid or remove catheter soon as possible. Once patients are cleared for discharge they must be aware of the steps to take to insure proper bladder

The first stage of the process is assessment. Roper et al (2001) refer to this process as ‘assessing’ indicating an ongoing activity; this encourages nurses to recognise the on-going nature of this initial phase. The assessing stage includes gathering information about a patient, reviewing this information, identifying actual and potential problems and prioritising (Roper et al 2001). Roper et al (2001) explain the importance for assessing, as early as possible in the patient’s stay. Extensive, in-depth information may not be gathered on an initial assessment, however any information obtained contributes towards individualised care (Roper et al 2001). Ambrose and Wittig (1998) explain that the initial assessment becomes a foundation for ongoing assessing and holistic care. Barrett, Wilson and Woollands (2009) concord with Roper et al and Wittig in that assessing is an ongoing process and elaborate on this explaining that assessment should not be confused with admission. They state “an admission tends to be a one-off process when you first meet the patient, whereas assessment carries on throughout your relationship with the patient” (pg22). Assessment enables the nurse and patient to identify actual and potential problems. Although, some problems can be directly related to biological needs, holistic needs must be considered, i.e. psychological state and cultural/social standing

Accessible multidisciplinary services including assessment (urodynamics investigation where appropriate), diagnosis and management for people with urinary incontinence and other bladder dysfunctions.

For many people, getting older can be difficult because of fear. They worry about what could happen to them or what type of diseases they might develop later on. To become a more mature adult is a stage of life that each individual will experience in a certain point. Statistics shows that eighty-eight percent of those of sixty-five years of age and older have at least one chronic health condition such as diabetes, dementia, Parkinson’s disease or cancer. (ezinearticles.com). This scholarly essay will focus mainly on urinary incontinence (UI) which is a common health problem that elderly may have.

Urinary Incontinence (UI) is another medical condition that commonly occurs in old age. It is basically the leakage of urine due to poor control of the bladder. UI increases with age and affects women more than men until the age of 80, after this age both men and women are equally affected. (Santiagu 2010, p. 106)

Gomelsky and Dmochowski (2011) nonetheless maintain that it is mostly considered as a natural part of the ageing process. As a result, nurses should be conversant with the prevalence of urinary incontinence in older people typically the housebound and those with mobility problems (Horrocks et al., 2004).

General and Family Medicine patients make up the patient population on 8 Bedtower (8BT) at UNC Chapel Hill Hospital. On this 31-bed unit, we have encountered patients whom are incontinent, either urine, stool, or both. Urinary and fecal incontinences are health complications that have a profound impact on an individual’s health, and in particular, their social and psychological well-being. It is a widespread problem in all healthcare settings and incontinence care is a salient task for healthcare providers, patients, and caregivers alike.