Reflective Essay on Assessment and Management of Urinary Incontinence

Your GP can assess whether you have incontinence, decide which type of incontinence you have, give general advice on controlling symptoms of incontinence, provide information on pelvic floor exercises and bladder retraining, and give treatment for incontinence with prescribed medicines. If lifestyle changes and treatments don't solve the problem, your GP can refer you to a continence adviser or specialist.

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.

For nurses, (P) on 2 South caring for patients with urinary catheters, will education, on the importance and proper use of a nurse -driven indwelling catheter removal protocol (I), change knowledge on the use of the nurse driven protocol, as compared to knowledge before receiving an education, (C), as evidenced by (O), change in knowledge in the use of the nurse -driven indwelling catheter removal protocol, and CAUTI rates as evidenced by, pre and posttest scores and CAUTI audits after three months? The project will utilize a

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

Bernard, M.S., Hunter, K.F., & Moore, K.N. (2012). A review of strategies to decrease the duration of indwelling urethral catheters and potentially reduce the incidence of catheter-associated urinary tract infections. Urologic Nursing 32(1)

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,

After an initial search of scholarly databases, a total of fifteen articles was selected for their application to the PICO question. An appraisal of each article uses the following format:

The three questions addressed were: Who should receive urinary catheters, what are the best practices for those who require urinary catheters and for preventing CAUTI’s acquired from urinary obstruction. This updated guideline offers recommendations for the appropriate use of indwelling catheters utilizing appropriate indications for usage, proper techniques for insertion of indwelling catheters, proper techniques for indwelling catheter maintenance, quality improvement programs, administrative infrastructure and surveillance including identifying those at risk for CAUTI (Gould et al, 2009). The strengths of this guideline are that many questions and scenarios are examined in this document and answered in explicit detail. Any healthcare professional can refer to the document to answer most practice based questions that are posed to them regarding indwelling urinary catheters. One weakness identified is the lack of an alternative explored for the external catheterization for female patients, for example the Purewick solution. However, the Purewick was not released until January 2016 and this guideline was last updated in 2009. Integrative Review

Urge incontinence is defined within the context of overactive bladder syndrome. The overactive bladder is characterized by bothersome urgency (a sudden and strong desire to urinate that is not easily deferred) (Abrams et al, 2002). Overactive bladder is typically associated with frequent daytime voiding and nocturia, and approximately 37% will experience urge urinary incontinence (Stewart et al, 2003).

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 next step will focus on educating the unit’s staff. Employees that place an indwelling catheter will be required to go through a refresher course on proper insertion technique, indications for catheterization, and catheter care. Additionally, there will be a class on the new flow sheet created to track indwelling catheters (Andreessen et al., 2012). Posters with information pertaining to catheter care, CAUTI prevention, the new charting system, and alternative bladder management systems will be placed in highly visible areas such as break

According to the evidence based research done by Overton Brooks VA Medical Center “implement a bladder retraining trial in compliance with the NPSG to prevent CAUTIs. The goal was to decrease infection risk by decreasing the length of time catheters were in use and reinsertions. Decreasing reinsertion rates not only reduces infection risk but also decreases post-op length of stay, saving money and resources.” (Shreveport, 2013).The way I would share with my employment would be to have in service education for all staffs and share the information about normal bladder function. Also instruct nurses to teach patients to have voiding schedule that incorporates regular delay of voiding by using interruption and relaxation techniques, self-monitoring,

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.