A nurse has identified that the patient has overflow incontinence
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It is estimated that 14 million men, women, young people and children are living with bladder problems, roughly the equivalent number of the over-60s population in the UK. It is also estimated that 61% of men in the general population experience lower urinary tract symptoms and around 34% of women are living with urinary incontinence (NHS England, 2018). Show
The British Geriatric Society recognises several causes of incontinence (Box 1) (British Geriatric Society, 2018). Different causes of urinary incontinence will require different treatments and, once a diagnosis has been made, treatment will be relatively straightforward. Box 1.Causes of urinary incontinenceTreatments for urinary incontinenceNon-surgical treatments include: Additionally, there are people who will benefit from the use of incontinence products, such as absorbent pads, handheld urinals and urinary catheters. Diagnosis and supportInitial diagnosis will be based on symptoms and signs, including the onset of incontinence, identifying which, if any, treatments have already been tried, and how the patient is coping with the condition in their day-to-day life. Nurses are ideally placed to perform the initial assessment and management of incontinence, a stage of the care pathway that is crucial, but that is often poorly executed due to various obstacles. Nursing staff have identified environmental barriers to providing optimum care, such as lack of time and work pressures, and many consider urinary incontinence to be a low priority, preventing the facilitation of interventions. Outdated attitudes and lack of basic understanding of incontinence also limit nurses' engagement in continence care, with many nurses expressing the opinion that incontinence is a normal, expected consequence of ageing (Borglin et al, 2020). Many people experience unacceptable and avoidable embarrassment and social isolation because of a lack of support to help them manage incontinence. The Royal College of Nursing (RCN) (2021) recognises that continence care is an essential part of a nurse's role and an aspect that needs to be undertaken sensitively and competently to ensure that patients who have a bladder or bowel problem are supported to manage it. People who experience incontinence require health education around the transient causes of the condition and to be educated on the reversible causes. These include (DeMaagd and Davenport, 2012): Incontinence in older adults may or may not be associated with the genitourinary system. Pharmacological causes and contributors should be considered, especially if the patient is taking multiple medications. Primary care providers and specialists should work as a team to manage patients with urinary incontinence and to evaluate the broad spectrum of factors that may contribute to incontinence in older adults. According to Hunter and Wagg (2018), nurses have the potential to identify people with incontinence, establish appropriate interventions and support, and provide valuable education to empower patients. Nurses caring for patients with continence problems must promote consistent continence care practice and work to improve the experiences of people with continence needs. The latest Excellence in Continence Care guide (NHS England, 2018) promotes equal access to services and treatment for all. It is applicable to children, young people, adults and elderly people, and takes into consideration each person's diverse needs from assessment and diagnosis to treatment to recovery—nurses are well placed to drive advances in clinical outcomes and reduce health inequalities. What is the treatment for overflow incontinence?Overflow incontinence caused by an enlarged prostate is often treated with surgery to remove the obstruction, including transurethral resection of the prostate (TURP), a common procedure used to treat BPH. A catheter. Some men may need a catheter to allow the bladder to empty normally.
What is the most likely cause of overflow incontinence?The main cause of overflow incontinence is chronic urinary retention, which means you can't empty your bladder. You may need to urinate often but have trouble starting to urinate and completely emptying your bladder. Chronic urinary retention is more common in men than in women.
What interventions can a nurse take to treat urinary incontinence?Interventions. Pelvic muscle exercises (also known as Kegel exercises) work the muscles used to stop urination, which can help prevent stress incontinence. ... . Timed voiding can be used to help a patient regain control of the bladder. ... . Lifestyle changes can help with incontinence.. What interventions can be done to help patients with incontinence?Educate the patient and their carers
Discourage the use of known bladder irritants (such as coffee, alcohol and soft drinks). Provide education on continence products if required and: check and assist the older person to change their disposable pads after each episode of incontinence if necessary.
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