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Comprehensive Assessment and Treatment of Bladder Incontinence for Quality Elderly Care

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ilya
23 diapositives · 345 Views · Jul 13, 2014

Explore documented history and impacts of symptoms on quality of life due to bladder issues. Learn about effective services, best practices, and areas for improvement in elderly continence care.

#comprehensive assessment and treatment of bladder incontinence for quality elderly care #comprehensive assessment and treatment of bladder incontinence for quality elderly care ppt #powerpoint #presentation
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Comprehensive Assessment and Treatment of Bladder Incontinence for Quality Elderly Care
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  1. Documented history-Bladder Our Site: <65 95% 65+ 89% (52% 2006)

  2. Impact of symptoms on Quality of Life measured Our Site: <65 50% 65+ 62% (12% in 2006) – need to ask about impact of incontinence on daily life (question on proforma) and patient’s attitude (may be passive through ignorance)

  3. Summary of results (comparison 2010vs 2006)Was frequency of FI documented? Our Site: Documented 65+ 100% (100% in 2006) <65 100%

  4. Is there documented evidence of a bowel history? Our Site: 65+ 100% (80% 2006)<65 100%

  5. Does patient have documented treatment plan? Our Site: 65+ 94% (73% 2006)<65 100%

  6. Documented evidence of full discussion with patient of causes and treatments of FI? Our Site: 65+ 75% (60% 2006) <65 92%

  7. What works in our service? • Community and inter-speciality liaison • A comprehensive service • Integrated service provision • Assessment led service • Multidisciplinary teamwork • Link Nurses • Continence nurse ward rounds • Teaching and training

  8. What works in our service? • Agreed pathways urogynaecology urology colorectal Agreed referral criteria (in keeping with NICE) OPAL team (older persons Liaison) screens all in-patients age 70+ in acute medicine POPS team (proactive older person undergoing surgery) screens all in-patients undergoing surgery

  9. What works well in our service? • Clinical Governance • Improved documentation by regular audits • 2monthly MDT integrated pelvic floor continence service meeting • 2monthly CNS forum meeting-which includes the community services and the contruted universities

  10. What works well in our service? • Patient involvement guidelines Information leaflets patient user group meetings

  11. Barriers • Institution providing insufficient time for link nurses training days ●wards short of staff (nurses/doctors state this as reason for not completing assessment) Patient’s acceptance Patient’s perception

  12. Areas for improvement - FI GSTFT in upper quartile for 65+ and <65 (nominated centre of excellence at NACC launch) BUT • Stool charts • Clear documentation of causes in 65+ • Sharing of treatment plans with patients / carers • Quality of life • Patient own goals for treatment (65+) • Patient information (e.g. contact for Bladder and Bowel Foundation)

  13. Elderly care - winners of UK integrated continence Team of the Year