Improving Continence Care at Providence Continuing Care Centre Kingston

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Improving Continence Care at Providence
Continuing Care Centre (Kingston)
St. Marys of the Lake Hospital sitePilot Unit
16 Bed Geriatric RehabilitationBonnie Austin,
RN Kim Fortune, RN Marlene Dumond, RN Donna
Dickey, OT Duncan Gow, PT Beth Simons-Chambers,
RN, MSc Maureen McGinn, Program Manager Dr.
Chris Frank, Clinical LeaderJan Linscott,
Project Leader (email linscotj_at_pccchealth.org)

• What Was Already Happening
• Jan 04 Continence identified as a concern,
  Advanced Practice Nurse (APN) hired
• March 04 Conducted focus groups and stakeholder
  analysis
• May 04 Formed interdisciplinary team to lead
  improvements in continence care
• June 04 Indications of environmental readiness
  evident at the unit level
• July 04 APN enrolled to become a Nurse
  Continence Advisor
• Aug 04 Invitation from HRCC to join IC 5, and
  received endorsement of Chief Nursing Officer
• Nov 04 Urinalysis bladder scan on pre-printed
  adm. orders

A P S D
Outcomes Gaps
Cycle Process Flow Map Apr 05 Initiation of
assessment dependent on NCA consult June 05
Continence an admission goal at
multidisciplinary rounds Sept 05 Revise process
to initiate assessments on day of admission
Bladder Health Teaching for Patients
A P S D

• Brochures Provided
• Tips for Better Bladder Control
• Hydration Preventing Constipation
• Pelvic Floor Exercises (Kegels)
• Hygiene Product Information

Cycle Education - ? of Champions Apr 05 7.5
hr workshop 4 nurses June 05 1 hr education
to all staff on Pilot Unit Sept 05 2nd 7.5 hr
workshop 3 nurses Aug/Sept/Oct 05 Posted
articles, myths facts, and poster for Healthy
Bladder Tips
A P S D
Cycle Assessment / Treatment Nov 04 2 nurses
try out IC 5 form Dec 04 Revisions to IC 5
form Jan 05 Finalize the form Apr 05 ? of
nurses doing assessments May 05 Chunks of Time
concept
NEXT STEPS

• Achievements Success Factors
• APN provided mentoring and coaching to 8
  Resource Nurses
• Assessment broken into Chunks of Time
• 32 patients assessed treated
• Professionals do ask and patients tell
• it hurts my pride, its embarrassing
• Challenges
• Continuity and consistency of care
• Skill mix and ratio of nursing staff
• Numerous organizational changes i.e. Program
  Management, multiple initiatives and competing
  priorities

Organizational Changes

• Aim Statement
• All clients experiencing UI will be identified
  within one week of admission will undergo
  urinary continence assessment and have a
  treatment plan implemented to maximize continence
  by time of discharge.