Incontinence is a health care problem that cannot be ignored, and the problem is growing geometrically as the population is aging. Continence care nursing is a growing area of nursing specialty that identifies, assesses and manages urinary, fecal and double incontinence. This nursing specialty looks at health care problems from a holistic point of view as it considers causative factors and the complications that accompany the management of urinary and fecal loss. Continence care nursing includes risk assessment, prevention and skin problems.
While the foundation for primary continence management is based in understanding the normal voiding process, the continence nurse will identify risk factors for both urinary and fecal incontinence as well as assess the overall condition of their patient. This includes getting the patient’s medical history, giving the patient physical examination, and building a profile of the patient’s voiding habits. The continence nurse also looks for factors that can complicate the situation like infection, impacted bowel, urine retention, skin damage and neurological abnormalities.
The primary continence care nurse is responsible for setting up an appropriate continence management program. The nurse will manage food and fluid intake, assist with bowel training and bladder retraining, oversee physical therapy, manage catheter and offer education to their patients. The nurse will also identify patients who require more in depth symptom analysis.
The advanced continence care nurse will perform the same assessments that a primary continence care nurse does as well as performing a detailed physical exam, fluoroscopic imaging, overseeing management of the patient’s condition, helping with pelvic floor rehabilitation/education, and fitting vaginal pessaries.
Both the primary and advanced continence care nurses know the physiology and anatomy of the digestive system including the GI, GU and integumentary systems. The continence care nurse is comfortable dealing with elimination problems and can collaborate with other health care professionals to help the patient manage their continence problem.
With over half of the elderly populations in institutions having continence issues, the continence care nurse is proving to be a valuable addition to a comprehensive and holistic approach to dealing with the challenges of continence health.
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