Incontinence management
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Modules - Incontinence Management
COMPREHENSIVE ASSESSMENT IDENTIFIES CAUSE OF AND TREATMENT FOR URINARY INCONTINENCE
There are many potential causes of urinary incontinence. Consequently, there are many potential treatments. Determining the first so that you can decide upon the second is the primary goal of a basic resident evaluation, a first step recommended in all best-practice guidelines for managing urinary incontinence.
Though this first step is clearly a cornerstone for effectively managing incontinence, even nursing homes that purportedly provide quality services in this area often fail to follow through with recommended assessment procedures (1). In one study conducted in 30 nursing homes, we found that the staff (and here we include physicians) had obtained targeted histories for most incontinent residents, but had performed comprehensive physical exams for less than 14% of these residents (1). Rarer still were recommended dip stick urinalyses, post-void residual measurements, and 24-hour voiding records. Perhaps most surprising of all is that half of the participating nursing homes had what are considered "good" scores on two widely used quality indicators for incontinence care (1).
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