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FOCUS ON MINIMUM STANDARDS OF CARE
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UROLOGY AND CONTINENCE CARE TODAY
2018,Vol 1, No 1
C
ontinence is an individual’s
voluntary control of their
bladder or bowel. It is a
crucial part of dignity and a firmly
entrenched societal norm. We are
born without it and develop it as we
mature into early childhood; intense
embarrassment can exist for those
who lose or never gain this control,
making it hard for them to reach out
to health and social care workers who
can help them adapt to, resolve, or
manage this problem.
With a focus on urinary
incontinence in adults, this article
explores recent best practice guidance
to help healthcare professionals,
who have contact with people with
continence needs, to be aware of their
role and responsibilities and the best
practice standards available to guide
training and development in the
delivery of continence assessment
and management.
The United Kingdom Continence
Society (UKCS) 2015 minimum
standards document states that those
Minimum standards of care:
an overview
NHS England (2015) conclude that
improved continence care with
integrated services across primary,
secondary and care home settings
will produce the following benefits:
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A better quality of life and
more independence through
finding solutions appropriate
to individual needs
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Less reliance on pads
and products by using
alternative treatments
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A reduction in admission to
hospital and care homes
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Fewer complications, such as
urinary tract infections (UTIs),
faecal impaction and
skin breakdown
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A reduction in costs
(NHS England,‘Excellence in
continence care’ [EICC], 2015).
WHAT SHOULD BE DONE IN
THE COMMUNITY?
Case finding
Embarrassment and a lack of
awareness of the possibility of
improving or even curing continence
problems often blocks an individual’s
ability to seek help for their
condition. Being aware of who is at
risk and asking the right questions is
therefore an important part of clinical
assessment (NHS England, 2015).
Jaqui Walker, general practice nurse, Allanpark
Medical Practice, Stirling; freelance medical writer
IN BRIEF
Continence is an important and common problem and so nurses
have a responsibility to be able to screen for and perform a basic
assessment of incontinence.
Resolution of continence issues is possible for many with the right
care and advice.
Primary care nurses need the education and training to be able to
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and to know when to refer on to specialist services.
KEY WORDS:
Continence care
minimum standards
Assessment
Referral pathways
Educational needs
and incontinence
Jaqui Walker
with continence care needs should be
assessed with the goal of making a
diagnosis and offering treatment, and
that it is only in a minority of cases
that this goal of treating and resolving
the problem may need modifying to
a goal of managing the symptoms. It
is tragic, therefore, that many people
with continence needs still suffer
in silence. The British Association
of Urological Surgeons (BAUS)
estimates that around three million
people in the UK experience urinary
incontinence and, of these, as many
as 60–80% have never sought medical
advice for their condition. Often, they
just see it as part of the aging process
(BAUS, 2018).
The‘FiveYear ForwardView’
document encourages health and
social care to work in tandem, utilising
the many resources the third sector
has to offer and empowering people
to have greater input and choice
around the management of their
condition (NHS England, 2014). This
model is ideal for continence care and
should guide healthcare professionals’
approach to achieving an excellent
service for people.
There are many advantages
in providing excellent continence
care. In their guidance document,