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Continence care is not the weakest link

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VOL: 97, ISSUE: 20, PAGE NO: 53

Janet Holmes, MSc (Nursing), RGN, DipN, is nurse consultant, continence care, Mid Staffordshire General Hospitals NHS Trust

With the publication of Good Practice in Continence Services (2000) and The Essence of Care: Patient-Focused Benchmarking for Health Care Practitioners' bowel and bladder section (2001), continence care has finally come of age. We now have two frameworks within which services can be reviewed and developed.

With the publication of Good Practice in Continence Services (2000) and The Essence of Care: Patient-Focused Benchmarking for Health Care Practitioners' bowel and bladder section (2001), continence care has finally come of age. We now have two frameworks within which services can be reviewed and developed.

Some people argue that continence care should have its own national service framework, but I see it as a specialty that can be integrated into most health and social care initiatives, ensuring the continuing improvement of bladder and bowel care. Primary trusts need to develop and maintain the momentum of interest in continence care, in partnerships with service users, professionals and local primary care groups. And because of their influence in a range of care settings and specialties, nurses are ideally placed to make such partnerships a reality.

To develop a service based on collaborative working we need to identify the level and type of service required so that adequate resources can be allocated. This is a difficult starting point because prevalence figures are usually estimates of incidence.

Although continence problems are not life-threatening, most nurses will be able to recall situations in which incontinence has led to the death of an individual personality, self-esteem and ability to interact with family and friends. Continence problems are not selective of age, gender, social class or culture and we are all vulnerable. Nurses therefore have a responsibility to educate others on the subject and to lead by example through the maintenance of their own bladder and bowel health.

Promoting continence includes the early detection of any problems, aided by health promotion services that use trigger questions to identify those who are most at risk. Care in such a service requires pathways for referral and treatment that are accessible and appropriate to local need, and subject to audit and review.

The development of a modern continence service, which removes the barriers between health care settings, is a significant challenge. This is an ideal opportunity for nurses to take the lead and ensure that continence care becomes the strongest link in the rehabilitation process.

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