Continence Resources

Sylvie Hampton discusses some of the practical issues faced by ostomates and the management of skin and stoma
Sylvie Hampton MA, BSc (Hons.) DpSN, RGN is a Tissue Viability Consultant, Eastbourne.
Article accepted for publication: July 2007

Joanne Whiteley gives an overview of the need for holistic assessment of incontinent patients' skin
Joanne Whiteley RGN, BSc is Continence Services Manager, Kirklees PCT
Article accepted for publication: July 2007

Rectal interventions are a fundamental part of nursing care across all settings aimed at establishing whether effective bowel emptying is taking place. Functional bowel disorders, including constipation, are common conditions affecting many of the general population and often go undetected by both patients, who perceive it as their normal, and healthcare professionals, who may not include a thorough bowel assessment at every clinical contact due to time restraints, lack of knowledge, or fear of intimate procedures causing harm or embarrassment. An inaccurate or complete lack of appropriate bowel assessment can increase risk of harm or ill health for many patients and therefore should be an intrinsic part of everyday clinical contact. The Royal College of Nursing (RCN) recently reviewed its bowel care guidance (Fenton et al, 2019) to address some of the concerns around bowel assessment and management. With an ever changing workforce, multiple grades of registered and non-registered staff taking on additional tasks, it is prudent for all clinicians to review their current knowledge and practice to ensure that they are following the latest evidence-based guidance for safe and effective practice.

Rectal interventions are a fundamental part of nursing care across all settings aimed at establishing whether effective bowel emptying is taking place. Functional bowel disorders, including constipation, are common conditions affecting many of the general population and often go undetected by both patients, who perceive it as their normal, and healthcare professionals, who may not include a thorough bowel assessment at every clinical contact due to time restraints, lack of knowledge, or fear of intimate procedures causing harm or embarrassment. An inaccurate or complete lack of appropriate bowel assessment can increase risk of harm or ill health for many patients and therefore should be an intrinsic part of everyday clinical contact. The Royal College of Nursing (RCN) recently reviewed its bowel care guidance (Fenton et al, 2019) to address some of the concerns around bowel assessment and management. With an ever changing workforce, multiple grades of registered and non-registered staff taking on additional tasks, it is prudent for all clinicians to review their current knowledge and practice to ensure that they are following the latest evidence-based guidance for safe and effective practice.

Current Covid restrictions have forced many healthcare professionals to embrace technology and work in very different ways. Indeed, the traditional telephone has allowed the Newcastle continence service to provide a service to patients referred with all types of urinary incontinence. But, is it even possible to assess someone’s continence and devise a treatment plan over the telephone?

It is estimated that one in 12 children and young people in the UK suffer with a wetting or soiling problem, which can have a devastating impact on their family life, social life and self-esteem (NHS Modernisation Agency, 2003). Afraid of wetting themselves in class or on a school trip; too many children and teenagers are missing out on sleepovers and camping trips, being bullied and constantly trying to hide the signs of their ‘secret’.

Current Covid restrictions have forced many healthcare professionals to embrace technology and work in very different ways. Indeed, the traditional telephone has allowed the Newcastle continence service to provide a service to patients referred with all types of urinary incontinence. But, is it even possible to assess someone’s continence and devise a treatment plan over the telephone?

It is estimated that one in 12 children and young people in the UK suffer with a wetting or soiling problem, which can have a devastating impact on their family life, social life and self-esteem (NHS Modernisation Agency, 2003). Afraid of wetting themselves in class or on a school trip; too many children and teenagers are missing out on sleepovers and camping trips, being bullied and constantly trying to hide the signs of their ‘secret’.

Indwelling urinary catheters are still one of the most commonly used invasive devices in health care, with recognised significant risk factors, including catheter-associated urinary tract infection (CaUTI) and sepsis. Timely and successful removal of the catheter often falls to the responsibility of community nurses. There has been much debate about the optimum timing and circumstances for a successful trial without catheter (TWOC). This article looks at best practice guidelines and relevant clinical evidence to support healthcare professionals in making choices around TWOC procedures.

The development of an integrated children’s bladder and bowel service is a key recommendation from a number of national documents and helps ensure affected children are seen at the right time and place and by the right person. This facilitates potential cost savings in the long term, with resultant reductions in A&E attendance and secondary care referrals. The key reference document is the Children’s Continence Commissioning Guide, which sets out a clear service framework. By working with several services across the UK, a generic service model has been developed which supports appropriate interventions at both tier 1 and tier 2, including the development of care pathways to help reduce unwarranted variation and inequalities in the provision of care. The key to success with this model is also the empowerment of families to help them self-manage the child’s problem, which also fits within the NHS Long Term Plan (NHS England, 2019).