Continence issues is one of the most common reasons why people are admitted to residential aged care. As we acknowledge World Continence Week (15-22 June), we spoke to Karen Newby, senior clinical advisor at Asaleo Care and continence nurse advisor. Karen shares the most common mistakes made in continence management and provides practical tips and advice for improving care.
1. Lack of monitoring and established goals
Care plans for incontinence are unique to each resident and need to be measured, monitored and adjusted on a regular basis to ensure that residents continue to feel a sense of independence and can maintain their dignity. When continence systems are not continually monitored and adjusted, poor care occurs resulting in skin macerations, an increase in UTIs and discomfort.
How can this be achieved? Karen suggests to “apply consistent assessments of continence management to residents and monitor their toileting schedules, including any changes and frequencies.” Using this monitoring system, as well as following a routine, can also help to minimise costs ensuring items that are used are needed and not wasted.
“It’s important for carers to set key performance indexes and goals to strive toward achieving a higher standard in care,” Karen says. A good example of relevant KPIs can be found on the Global Forum on Incontinence website, which outlines 14 set KPIs that care providers can work towards.
2. Lack of communication between residents, continence teams and staff
There needs to be a good conduit between those that set the care plans and those that implement the care strategies. The conduit between the facility floor and assessors is important for adjustments and reviews.
“The residents themselves, along with their friends and families are the most familiar with the resident’s standard routine and source of discomfort. Ongoing communication with carers will help to shape their ongoing plan and ensure quality of care,” Karen says.
What can be done? Karen suggests that continence teams need to work in collaboration with nurses and carers by having regular meetings and reviewing management plans for patients on a case-by-case basis, rather than as a general practice.
Carers should keep detailed notes on residents’ preferences and care plans that can be referred to ongoing.
3. Outdated standards, products, tools and technology systems
“Outdated procedures, such as using rolled up towels or using zinc are practices that need to be changed. Products, services and technology are constantly changing and the types of products that can suit a resident’s needs are knowledge imperative in the aged care industry.”
The increase of newer products such as upgrades in the technology of pads, underpads and underwear available and Urego, which measures the amount in the bladder and informs the wearer to know when it is time to go to the bathroom, need to be communicated to residents.
When it comes to continence management Karen suggests a key KPI for nurses and carers should be to stay updated with the latest technology advancements and research in continence management to ensure that patients are receiving the most updated and preferred care.
4. Lack of regular training for staff
Many staff members do not have the proper training or techniques for managing incontinence. This leads to outdated and poor practices which use products covered in plastic which affects the wellbeing of patients.
How can this be improved? “Ensure that someone from the continence team is attending training sessions and has the tools needed to deliver training on-site to support educating the broader team.“ Karen says.
Consistent monitoring and assessment of residents is also important to delivery of continence care, as well as evaluating the effectiveness of the strategies in place, which will allow the nurse to develop the best type of care.
5. Insufficient time allocated
The care for residents with incontinence requires adequate time and focused attention, however, the continence portfolio holder is often limited in their time. This can often result in large staff turnovers, which ultimately affects the resident’s wellbeing.
Karen explains what can be done about this. “It’s pretty simple. Facilities need to dedicate one hour per week to continence portfolio holders to visit residents and work with the continence team to implement the best care plan.”
By putting a strong focus on all five recommendations outlined above, continence can be effectively managed, which will ultimately result in happier residents, carers and facilities.
If you are a care provider or a care professional and would like to know more about how to manage your continence products and ways to improve continence management in your facilities, reach out to one of our experts on 13 26 44.