Assessment, treatment and promotion is the way forward for continence care, not just containment, says Doreen McClurg
Continence care is an essential part of basic health care and is the responsibility of all health care professionals. Continence was one of the initial nine Essence of Care Benchmarks and is a theme (along with arthritis and depression) in Phase 11 of the Prevention Package for Older People. Why is it then we are still hearing time and time again that containment rather than assessment, treatment and promotion, is the norm?
Integrated continence services are apparently a ‘dream rather than a reality’ (Wagg 2008), with health workers striving to provide quality care in the face of tight budgetary constraints and increased workloads. Potential barriers relating to integration of services are:
- individual factors include knowledge, for example, limited awareness of management options;
- beliefs about urinary incontinence (for example, urinary incontinence is an inevitable part of ageing;
- attitudes towards older people;
- team/group barriers such as poor internal communication systems, low level of commitment from co-workers;
- organisation/system level barriers including high work load, limited access to resources such as bladder scanners, perceived lack of institutional support for improving continence care (Cheater 2009).
Whilst recognising that basic continence education at the undergraduate level may only be part of the solution to improving standards, it is a fundamental prerequisite to achieving good practice in continence care. But are our newly qualified health care staff receiving basic continence education to adequately meet the needs of an increasingly older population?
This project will establish the extent and nature of UK undergraduate continence education in nursing, occupational therapy, physiotherapy and medicine. It will also explore the extent to which newly qualified staff feel prepared to care for people with continence problems in clinical practice.
Two large scale surveys will be undertaken:
- A UK-wide survey of higher education institutions which run undergraduate nursing, physiotherapy, occupational therapy and medical programmes to gain information on the continence content;
- A survey of recently qualified health care professionals (within one year) to assess if they felt their training in continence was adequate for clinical practice.
The Dunhill Medical Trust is funding this two year research project which starts 1st March 2010. If you are involved with undergraduate education, are a recently qualified health care professional, or are interested in continence keep a look out for further updates.
Doreen McClurg PhD MCSP, NMAHP Research Unit, Glasgow Caledonian University
Cheater F (2009) Overcoming the barriers to optimum continence care: the need for an expanded approach to implementation. International Journal of Older People Nursing; 4: 70-75.
Wagg A et al (2008) National Audit of Continence Care for Older People: Management of urinary incontinence. Age and Ageing; 23: 39-44.