Continence education 2024.pdf

Purpose of Continence Care & Bowel Management Program: Policy # 6.241 Objectives of the Continence care & Bowel Management Program September 2024 9/19/2024 2  Urinary Incontinence is any involuntary leakage of urine...

Purpose of Continence Care & Bowel Management Program: Policy # 6.241 Objectives of the Continence care & Bowel Management Program September 2024 9/19/2024 2  Urinary Incontinence is any involuntary leakage of urine 20% of people over the age of 75 have problems with incontinence What is Different solutions include: surgical intervention, Incontinence? dietary changes, toileting schedules, medication, Pelvic muscle exercises Use of absorbent products September 2024 9/19/2024 3 Levels of Continence September 2024 9/19/2024 4  Definitions/Descriptions Toileting: The process of encouraging the Resident to use Constipation: The difficulty in some type of containment device passing stools or incomplete or Continence: The ability to Incontinence: The inability to in which to void or defecate. The infrequent passage of hard stools control bladder or bowel function control urination or defecation containment device may be the (Mosby Medical, 2002, Nursing & (Mosby Medical, 2002, Nursing & (Mosby Medical, 2002, Nursing & toilet, commode, urinal, bedpan Allied Health Dictionary) (Bristol Allied Health Dictionary).In RAI- Allied Health Dictionary).In RAI- or some other type of receptacle, Stool Chart). In RAI-MDS 2.0, MDS 2.0, continent is defined as MDS 2.0, incontinent is defined but does not include briefs. constipation is defined as 2 or complete control. This includes as inadequate control of bowel all Toileting is for the purpose of fewer bowel movements passed the use of an indwelling catheter or almost all of the time; and for voiding and defecating not for in a 7 day period or strains more or ostomy device that does not bladder, multiple daily episodes just changing briefs. (RNAO, than one out of four times when leak urine or stool. of incontinence. 2005, Nursing Best Practice having a bowel movement. Guideline - Promoting continence using prompted voiding). September 2024 9/19/2024 5  What is Bowel Incontinence? Bowel incontinence, also called fecal incontinence or anal leakage, is the unintentional loss of stool and/or gas. There are many reasons why bowel incontinence may occur. An assessment can help to narrow down the causes and allow you to establish an effective plan for prevention and management. September 2024 9/19/2024 6  Bowel incontinence can be caused by many different factors. If the muscle that controls the opening and closing of the anus is weakened or damaged, fecal leakage becomes a risk. Other conditions like long-term diarrhea, constipation or Causes of nerve damage can also increase the risk. Fecal leakage has been associated with illnesses such as diabetes, multiple sclerosis, hemorrhoids and dementia. Bowel Incontinence Cognitive impairment can also be a risk since it can make it difficult to remember the way to the toilet, or even recognize the need to go. Other factors may include not drinking enough fluids during the day, which can result in constipation and bladder irritation, and lead to urgency feelings and fecal leakage. Well-hydrated urine is pale yellow. Urine that is dark or reduced in volume could indicate the need for more fluids. September 2024 9/19/2024 7  Establishing a bowel management plan A bowel management plan is a person-centred care plan to manage, treat and prevent bowel problems. To set up a good plan, you'll need to collect information and do an assessment to detect risks, as the appropriate treatment for a resident's fecal incontinence will depend on the underlying cause of the problem. Here are some factors to consider when making an incontinence assessment: Managing Toileting ability, cognition, and mobility to ensure right help at the right time Bowel Bowel patterns and stool consistency, to ensure regular bowel movements and normal consistency Incontinence Diet and drinking habits, to identify dehydration and risks of constipation and diarrhea Skin care status, to identify fragile skin and risks of skin problems Medicines that could have side effects on the bowel Other factors that might influence bowel habits (it's important to find out what the resident considers normal bowel habits) September 2024 9/19/2024 8  Types of Urinary Incontinence September 2024 9/19/2024 9  Ensure the Resident is well hydrated Managing Identify risks of constipation Bowel Incontinence Medications for IBS, Chron's Colitits Increase fibre or decrease fibre September 2024 9/19/2024 10 Types of Bowel Incontinence 9/19/2024 11 Bristol Stool Chart September 2024 9/19/2024 12  Documentation Responsibilities September 2024 9/19/2024 13  Protection Products are made to retain urine & keep skin dry over a long period of time What is Change Average of 2 to 3 Incontinence changes a day. Morning, afternoon and Care? evening Toileting Assisting the Resident to the toilet routinely can improve their Autonomy and may minimize episodes September 2024 9/19/2024 14  Urine passes out of the body and into the absorbent product and is then How do wicked away from the skin Absorbent The absorbent top core keeps the surface dry Products Liquid is then pulled into the bottom core where it is turned into a gel to prevent the Work? urine from coming back into contact with the skin The product's surface stays dry therefore helping the skin's surface to stay dry September 2024 9/19/2024 15 Ensure You Choose the Right Product & the Right Fit The size doesn't The product will relate to the leak if the size is absorbency not right September 2024 9/19/2024 16  Product Selection Depends on: Waist size Level of incontinence Gender Level of dependency for continence care Individual's Quality of life September 2024 9/19/2024 17  Speak to your Tena Rep if you have any questions about sizing and they can assist you in choosing the correct product for the Resident Tena Reps There are Tena kits on each Home area that have recently been updated Notify your manager if you are interested in becoming a Tena rep September 2024 9/19/2024 18  It can be very difficult to accept incontinence It has a negative impact on quality of life: Decreased self -esteem, affects inter- personal relationships, Impact on Can cause depression, apathy, loss of autonomy Dignity & Negative Physical Impact: General discomfort, skin health issues, sleep issues, sexual issues Skin It is a common phenomenon Integrity It is not just a problem in aging Men are less likely to accept that they are incontinent due to their perception of masculinity and emotional inhibition Can cause skin breakdown  Soaker Pad Use We are eliminating soaker pad use at Research shows that Make pressure reduction WHY?? Woodingford Lodge for washable soaker pads: mattresses less effective many reasons They are NOT supposed Are not required if the Increase the risk of to be used for resident is wearing a pressure ulcer &/or repositioning or moving properly fitted create tears in the skin a resident as they incontinence product the risk of staff injuries