Improving nurse assessment, management and treatment of incontinence in residential care

Management of incontinence in residential care can be challenging and time consuming. A report from the Continence Foundation of Australia (Cahill et al., 2011) identified the prevalence as 70.9% in long-term care facilities. Given the high number of affected aged care residents, it is understandable many nurses consider it to be inevitable. Many people experiencing incontinence and living in care are not consulted about their care because nurses don’t recognise the significance for the person. Consequently it is not a priority which signifies a lack of awareness of the importance to maintain self-esteem, function and health for older people. In focussing on containment and regular toileting rounds rather than individualising care, many aged residents are provided with pads and expected to hold long enough to toilet resulting in incontinence. This indiscriminate use of pads increases costs reported as $7.1 billion in care facilities or $34.96 per day per resident. Research within residential sections of Multi-Purpose Services is scarce and previous investigations have revealed continence issues (Dickson et al., 2001). As a Continence Advisor and student researcher, Ethics approval was obtained to assess and provide support to improve continence management by assisting staff to evaluate and improve their continence assessment and treatment benefitting their residents. Action Research methodology was chosen because it is educative and encourages sustainability through staff involvement. Over two years staff worked with the Continence Advisor to identify and address continence problems using cycles to plan, implement and evaluate actions. In the evaluative phase the nurses were encouraged to provide feedback on the effectiveness of the research, education and project process. The methodology proved to be the best method to encourage nurses to identify and implement individualised programs for their residents. They also became more aware and proactive through improved continence assessment, treatment and management. References: Cahill,, B., Donhardt, R., Tucker, I., Chiarelli, P., & Murray, M. (2011). The economic impact of incontinence in Australia. In: Deloitte Access Economics (ed.). Continence Foundation of Australia. Dickson, L., Owens, J., & Alexander, C. (2001). Continence assessment and management in older clients in rural New South Wales. Australian and New Zealand Continence Journal, 7 (2).