Continence Promotion and Care


Your Healthcare CIC: Bowel support service

Many of the learning disability (LD) team’s service users were prescribed laxatives to manage constipation and the team recognised that information given to prescribers was more informed when LD nurses were involved. To reduce reliance on the one team member who had had additional training in bowel management, an information pack and assessment tool were created. The content was agreed with the bladder and bowel team and all LD nurses were trained on their use. The new resources enabled them to carry out robust assessments, which were shared with the patient’s GP to aid prescribing decisions. The resources proved to be a great help to staff, and reduced the number of unnecessary daily laxative medications that were prescribed to patients.


Betsi Cadwaladr University Health Board: Healthy bowel and bladder sessions

The North West Wales Paediatric Continence Team started teaching 9-11-year-olds area-wide about daytime wetting, constipation and bedwetting. Using costumes, balloons, coloured water and painted salt-dough stools, the team shows children how the bladder works and how to keep it healthy. Feedback has been positive and children who did not feel comfortable seeking help have been supported.

Leeds Teaching Hospitals NHS Trust: Continence Promotion Team

In response to there being no formal education on continence care at the trust, documentation such as the urinary and faecal incontinence care plan was developed to enable staff to personalise care and encourage them not to use pads as a first-line aid. Over 1,000 staff received continence training, stocks of catheter fixation devices increased, and the formulary of pads available in the trust was streamlined to ensure these are a last resort and meet a patient’s needs.

Royal National Orthopaedic Hospital NHS Trust: Neuro-urology nurse-led Covid-19 recovery

This project aimed to reduce wait lists through activities that needed no on-site medical input. Nurse-led activities to mitigate the risk of harm to patients with spinal cord injury were implemented, and nurse-led consultant, flexible cystoscopy and sexual function clinics were launched. Between 80% and 100% of patients were reviewed in a timely manner, all referrals were made and diagnostic tests were booked.

Cambridgeshire and Peterborough NHS Foundation Trust: Rebranding and promoting the bladder and bowel service

New staff were employed, who were passionate about continence and working as a team to promote the rebranded service. Training was revamped, and new teaching models, care plans and assessment aids were introduced. As a result, interest in bladder and bowel health increased and staff began working on a haematuria tool for catheter patients.

Lewisham and Greenwich NHS Trust: Reducing containment product use in the community

The trust was spending £650,000pa on containment products for community patients. Integrating the community and hospital teams, and introducing assessment and treatment pathways alongside training for all staff, led to savings of £100,000pa, despite an increase in referrals. The number of patients on products also reduced.

South Eastern Health and Social Care Trust: Developing a community trial removal of catheter service

This service was set up so patients had access to a trial removal of catheter service in their own community. Patient information leaflets were developed, along with a community policy and procedures. Wait lists for hospital-based removals reduced, and surveys showed patients are well informed about their condition and happy with the service.

Landermeads Nursing Home: Quality of life and continence promotion in long-term dementia care

This nursing home ‘grows its own’ staff and its training focuses heavily on empathy. Problems due to inappropriate continence products were addressed and products were updated. As a result, residents were happier and their independence increased. Behaviours of concern, falls and urinary tract infections were also reduced.

Northern Care Alliance NHS Foundation Trust: Continence promotion and education

To address a lack of continence management education for care home staff and trained nurses, weekly and monthly sessions on continence and catheter care and insertion were held in care homes. Feedback was so positive, a package was specifically developed for trained staff. Nurses in care homes were also invited to training sessions on digital rectal examination and catheterisation.

University Hospitals of Leicester NHS Trust: Purewick female external catheter as urinary catheter alternative

The aim of this improvement project was to introduce the Purewick, a female external catheter, trust wide to prevent unnecessary urinary catheter insertion and incorrect pad usage, reduce moisture-associated skin damage and prevent patient harm. More than 900 staff were successfully trained on its use and placement, which led to it being rolled out to all relevant areas.