Page 63 - HA Convention 2016 [Abstracts (Day 1)]

Service Enhancement Presentations HOSPITAL AUTHORITY CONVENTION 2016

F3.4 Clinical Safety and Quality Service I 14:30 Room 421

A Person-centred Approach to Continence Care for Neurosurgical Patients
Chau CW, Cheng BW, Chan SHS, Poon CYM
Department of Surgery, Shatin Hospital, Hong Kong

Introduction Tuesday, 3 May

Urinary incontinence in neurosurgical unit is a common problem. Urinary incontinence of most of the patients may associate
with cognitive and/or motor deificts which we called functional incontinence. Functional incontinence was defined as unable
to pass urine in the bathroom in time due to physical and mental condition. Studies have shown that functional incontinence
is associated with stroke outcomes which resulted in not only physical discomfort but also impaired body image. In our unit,
a ward-based continence training programme has been conducted for patients with functional incontinence. The programme
aimed at achieving person-centred care by meeting patients’ physical and psychosocial needs and enhancing early
rehabilitation.

Objectives

(1) To help patient restore normal or acceptable micturition status within their capacity of motor function; (2) to increase the
competency of nursing management of urinary incontinence; and (3) to increase awareness and promotion of continence.

Methodology

(1) A basic screening form was developed to screen the target patients. (2) Target patients was recruited based on the
inclusion criteria. (3) Target patients and carers were briefed by primary nurse to seek for agreement and cooperation.
(4) A signage was used to remind all staff. (5) The period of continence training programme was four to eight weeks. (6) A
continence training chart was adopted to record the incontinent episodes and communicate for training time schedule. The
training include timed and prompted voiding management depending on patients’ physical and mental capacities. (7) A series
of talk and evaluation were performed to all nursing staff to the continence training in competency.

Results

From September 2015 to December 2015, a total of 20 neurosurgical patients from our unit were recruited to continence
training programme

Conclusion

14 patients (6 were male and 8 were female) were successful to restore normal continence status and four patients were
still not successful in the continence training programme in eight weeks due to moderate cognitive impairment. 2 patients
were tranferred back to acute hospital. Moreover, evaluation result demonstrated all nurses in our unit were familiar with
and competent of the continence training programme. In conclusion, person-centred approach emphasizes understanding
individual needs and working to maximize their abilities. The continence program was effective in improving patient’s
continence status. The successful of the program was attributed by patient’s and staff’s positive attitude.

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