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Continence management plans
The purpose of a continence management plan is to help with the management of bladder and bowel control problems. A continence management plan has three stages: information gathering, goal setting and evaluation.
Information Gathering
At this stage, the carer or health professional should focus upon defining the level of care needed for the client and describing their bladder and bowel habits. The result from this stage help set goals for the continence management plan.
The key feature of any continence management plan should be development around the individual needs of each client. A 'blanket' plan will not be effective for every client as habits can vary widely.
There are three key activities within this stage. These include detailed assessment of:
- The client (physical, social and economic issues);
- Risk factors; and
- Causes of the client's continence issues.
Goal Setting
At this stage the information gathered in stage one should be synthesised into specific goals for the client, set with input from the client (where possible) and their family (if appropriate).
Each goal should written in language that the client and their family and carer can easily understand. A goal should be a simple statement which is specific and concrete, and it should be recorded in the client's file. It must relate directly to the information gathered earlier. Goals usually fall into the following categories:
- Independent continence - the client is able to reach the toilet in time and will therefore be dry.
- Dependent continence - the client is dry if there is a certain aid or type of assistance in place.
- Toileting program - the client is taken to the toilet or prompted to go to the toilet at specific times to minimise risk.
- Social continence - the use of aids and appliances to keep urinary leakage and odour contained.
Evaluation
Evaluation of a continence management plan is essential for the successful treatment of a client's continence issues. It provides feedback about progress for both the client and carer. It also allows for ongoing refinement of the plan. This evaluation should be undertaken on a regular basis, and should happen:
- If the patient's health or continence status changes,
- If the goals which have been set are not being achieved, or
- Every two months, if the plan is effective.
A continuous quality improvement approach should be used in this stage to document and implement changes that may occur as a result of evaluation. Each individual management plan should be discussed with every staff member who will have contact with the client. This will ensure that the management plan is executed consistently and not changed, for example, at the start of each shift.
Page last updated 29 Feb 2008