Resources: Continence and Constipation: assessment and management
The following resource is designed to assist Long-Term Care (LTC) homes with the implementation of the Promoting Continence Using Prompted Voiding and Prevention of Constipation in the Older Adult Population Best Practice Guidelines. Documents found in this resource are evidence-based, but it is not a program plan. Each LTC home is unique and each home is in various stages of guideline implementation. LTC homes are advised to use the resource at their discretion. For those resources that have copyright notations, it is recommended that LTC homes obtain permission from the primary author prior to implementing them within their setting. The Toolkit is a dynamic resource, and is being updated and revised on a regular basis by the LTC Best Practices Initiative team. Visit this site often to see what's new!
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| Resource | Link |
|---|---|
| Self Learning and PowerPoint Presentations | |
A Model for Excellence in Continence Care PowerPoint A well illustrated presentation on improving continence care developed by the IC-5 project. | ![]() |
Continence and Stroke PowerPoint A presentation on the impacts of stroke on urinary continence with interventions and a case study. Developed by the Ontario Central South Regional Stroke Program. | ![]() |
Continence/Constipation Workshop for RNs in Long-Term Care PowerPoint A presentation on hydration, prompted voiding, constipation and hygiene based on the RNAO Continence and Constipation BPGs with case studies, facilitator and participants’ guides. | ![]() |
Dealing with Urinary Incontinence Using Prompted Voiding – An Overview PowerPoint A succinct presentation on incontinence and prompted voiding based on the work done in the IC-5 and IC-3 Improving Continence Care Projects. Developed by the Northwestern Ontario BPG in LTC Initiative. | ![]() |
Drugs and Urinary Incontinence PowerPoint A presentation on medications that effect incontinence and drugs that treat incontinence developed by a pharmacist. | ![]() |
Prevention of Constipation PowerPoint A succinct presentation on constipation based on RNAO and other BPGs developed by the Northwestern Ontario BPG in LTC initiative. | ![]() |
Promoting Hydration in Older Adults: Fluid for Thought A presentation on causes, risk factors and interventions for dehydration developed by the Committee for the Enhancement of Elder Friendly Environments (CEEFE) Central South Geriatric Program (Ontario). | ![]() |
RNAO: Self-Learning Package - Continence Care Education A self-directed learning package for health care professionals caring for adult patients experiencing urinary incontinence developed by RNAO. | ![]() |
Ultrasound Bladder Scan Self Learning Package An in-depth learning package on how to use a bladder scanner developed by IC-5 Project. Contains a catheterization decision tree and a self-assessment test. | ![]() |
| Charts | |
Bladder Control Muscles An illustration showing the muscles that control the bladder emptying from the RNAO Self Learning Package for Continence (pg. 39) | ![]() |
Bristol Stool Chart A chart showing the different types of stools taken from the RNAO Continence /Constipation Workshop for RNs in Long-Term Care - Participant’s Package. | ![]() |
Catheterization A side view diagram showing the placement of a catheter in female bladder from the RNAO Self Learning Package for Continence (pg. 46) | ![]() |
Diagram of Urinary Tract An illustration of the urinary system from the front and side, useful for one to one education with staff, families and residents from the RNAO Self Learning Package for Continence (pg. 15) | ![]() |
Female and Male Urinary Tract An illustration of the structure of the lower male and female urinary tracts from the RNAO Self Learning Package for Continence (pg. 16). | ![]() |
Innervations of Urinary Tract An illustration showing how the urinary tract nerves come from the brain and spinal cord from the RNAO Self Learning Package for Continence (pg. 17). | ![]() |
Normal Micturation Cycle A diagram showing the bladder filling and emptying cycles and the muscles involved in this process from the RNAO Self Learning Package for Continence (pg. 18) | ![]() |
Pelvic Floor/Descent Illustrations showing the pelvic floor and a descended pelvic floor from the RNAO Self Learning Package for Continence (pg. 41). | ![]() |
Transient Causes of Urinary Incontinence A one page list of the major causes of incontinence. | ![]() |
| Fact Sheets / Pamplets / Pocket Cards / Logos | |
RNAO Fact Sheet: Incontinence: Breaking the Silence A fact sheet on urinary continence for patients and families with recommendations for action based on the RNAO Continence BPG. Available in French. | ![]() |
RNAO L’incontinence : Rompre le silence RNAO Fiche de renseignements pour la sensibilisation en matière de santé. | ![]() |
RNAO Fact Sheet: Constipation: Prevention is the Key A fact sheet on preventing constipation for patients and families with recommendations for action based on the RNAO Constipation BPG. Available in French. | ![]() |
RNAO La constipation : La prévention est maître RNAO Fiche de renseignements pour la sensibilisation en matière de santé. | ![]() |
Medications That Can Affect Bladder and Bowel Function A list of commonly used medications that impact on incontinence by brand and generic name. | ![]() |
Pelvic Muscle Exercises for Men An information sheet to teach kegel exercises to men with a diagram. | ![]() |
Pelvic Muscle Exercises for Women This is an information sheet to teach kegal exercises to women. It includes a diagram. | ![]() |
Preventing dehydration in older adults - Patient Education Pamphlet A 2-page pamphlet written in plain language using large print on how people can prevent dehydration in themselves. | ![]() |
Prevention of Constipation in the Older Adult Population – Snapshot This is a plain language, one page summary of the recommendations from the RNAO Constipation BPG for staff, families and residents. | ![]() |
Promoting Continence Using Prompted Voiding – Snapshot A plain language, one page summary of the recommendations from the RNAO Continence BPG for staff, families and residents. | ![]() |
The Bladder Issue BP Blogger Newsletter December 2006 A succinct, 2-page newsletter that covers myths and facts about urinary continence and toileting issues. Developed by the BPG in LTC Initiative Central South and The Long Term Care Resource Centre, Hamilton, Ontario | ![]() |
The Bowel Issue BP Blogger Newsletter – February/March 2008 A succinct 2-page newsletter with myths and facts about constipation, fecal incontinence and bowel programs. Developed by Regional Geriatric Program Central and The Long Term Care Resource Centre Hamilton, Ontario | ![]() |
The Fluids Issue BP Blogger Newsletter - June 2007 A succinct, 2-page newsletter that covers myths and facts about dehydration in LTC residents. Developed by the Best Practice in LTC Initiative Central South and The Long Term Care Resource Centre Hamilton | ![]() |
| Videos | |
| Websites | |
Anna and Harry Borun Center for Gerontological Research. Incontinence Management Training Module The definitive guide to implementing prompted voiding in LTC. A clearly written, self-learning package that breaks the process into steps-assessment, responsiveness, maintenance and audits. Includes voiding records, monitoring forms, MDS subscales, etc. Highly recommended. | ![]() |
Canadian Nursing Continence Advisor Association (CNCA) A National Association mandated to enhance the specialty of Nurse Continence Advisors (NCA) in Canada by promoting education, research, and clinical practice. The Nurse Continence Advisor (NCA) role is an independent practice model focusing on conservative methods of managing incontinence. | ![]() |
Improving Continence Care in Complex Continuing Care (IC-5) A collaborative project between five Ontario hospitals that improved continence care. This website has the resources developed during the project with many practical ideas for implementation. | ![]() |
The Canadian Continence Foundation A national non-profit organization for people with incontinence that has a detailed best practice guideline on urinary incontinence including diagnostic tests, treatments and flow charts on incontinence management in men, women and the frail elderly. Several consumer education resources are on the website. | ![]() |
The Hartford Institute for Geriatric Nursing This Institute out of the New York University College of Nursing has developed ConsultGeriRN.org as an evidence-based online resource for nurses in clinical and educational settings. Urinary Continence Nursing Standard of Practice Protocol: Urinary Incontinence (UI) in Older Adults Admitted to Acute Care is one of 22 BPGs developed by this organization on geriatric topics. | ![]() |
Wound, Ostomy and Continence Nurses Society (WOCN) Founded in 1968, the Wound, Ostomy and Continence Nurses Society (WOCN) is a professional, international nursing society of more than 4,200 healthcare professionals who are experts in the care of patients with wound, ostomy and incontinence. | ![]() |
| Education Resources | |
RGP's On-line Teaching Resources A collection of online teaching resources for specialized geriatric services developed by academic centers and national, provincial and state associations in Canada and the USA compiled by the Regional Geriatric Program of Toronto. Topics include: 3Ds (Dementia, Dilirium, Depression), incontinence, constipation, pressure ulcers, wound care, sleep disorders, falls, elder abuse, nutrition, and much more! | ![]() |
RNAO: Continence/Constipation Workshop for RNs in Long-Term Care – Facilitator’s Guide A workshop on continence and constipation. | ![]() |
RNAO: Continence/Constipation Workshop for RNs in Long-Term Care – Participant’s Package A workshop on continence and constipation for the participants. | ![]() |
| Other Resources | |
Joanna Briggs Institute: Management of Short Term Indwelling Urethral Catheters to Prevent Urinary Tract Infections An evidence-based practice information sheet for Health Professionals on catheterization that discusses the technique, care, etc. One of the series developed by the Joanna Briggs Institute in Australia, a leader in evidence-based practice resources. | ![]() |
Promoting Hydration in Older Adults – Food for Thought Poster This is a coloured poster that shows the risk factors for dehydration and uses the mnemonic (H2O) to help staff and families. Developed by the Elder Friendly Environments Coalition. | ![]() |
Rehabilitation Nursing Foundation Part of the Association of Rehabilitative Nurses (ARN), an American organization whose mission is to promote and advance professional rehabilitation nursing practice through education, advocacy, collaboration, and research to enhance the quality of life for those affected by disability and chronic illness. Have an excellent BPG on constipation. For more information, visit http://www.rehabnurse.org/about/researchfoundation.html. | ![]() |
Scottish Intercollegiate Guidelines Network A comprehensive guideline on urinary incontinence management in the general population. Includes assessment, physical and medical therapies. Also included are: audit tools; flow charts; and resource implications. The use of containment products is discouraged until a full incontinence assessment is completed. A quick reference version of the guideline is available. For more information, visit www.sign.ac.uk. | ![]() |
Tips and Tools for Everyday Living: A Guide on Stroke Caregivers – Section 10 Managing Continence A quick synopsis of the issues of urinary incontinence in stroke survivors, written in plain language with tips on helping with incontinence. Developed by the Heart and Stroke Foundation. | ![]() |
Urinary Catheterization A BPG that covers various types of catheterization with strong emphasis on prevention of infection developed by the National Health Service in Britain. | ![]() |
| Resource | Link |
|---|---|
Bladder Scan Quality Assurance Form An audit form to record regular tests on bladder scanners to ensure that they are functioning properly. | ![]() |
Bladder Scanner Authorization/Validation Tool An audit form that allows an observer to evaluate and record the step by step use of a bladder scanner. | ![]() |
Evaluation of IC-5: Improving Continence Care in Complex Continuing Care An evaluation that shows the parameters used and gives examples of charts and tables used to demonstrate the effectiveness of this approach. | ![]() |
IC-5: Audit Indwelling Urinary Catheter An audit tool for monitoring catheter use on a unit or in a LTC home. | ![]() |
IC-5: Knowledge, Attitudes and Beliefs Survey of Continence Care in Complex Continuing Care A survey on continence care. | ![]() |
Myths and Truths about Incontinence A one-page questionnaire on incontinence that can be used to measure success of an incontinence educational campaign. It includes answers. | ![]() |
St. Lawrence Lodge: Prompted Voiding Best Practice Guideline Quiz A one-page quiz on the RNAO Prompted Voiding BPG. | ![]() |
Toileting Schedule Audit An audit tool on resident level of continence, use of continent products and frequency of toileting. | ![]() |
Program Evaluation: The basics Developed for public health units, it is equally applicable for programs developed in long term care particularly as it considers constraints in human resources and finances. The whole toolkit can be accessed at: http://www.phac-aspc.gc.ca/php-psp/toolkit-eng.php. | ![]() |
The Evaluation Center – Western Michigan University This contains checklists and tools for planning your evaluation. | ![]() |
Ontario Injury Prevention Resource Centre. There is a link to the stages of evaluation. This outlines the five steps in the evaluation process, and provides links to the introduction and overview of the program evaluation toolkit. | ![]() |
Public Health Agency of Canada - A Guide to Project Evaluation: A participatory approach This evaluation guide provides an easy-to-use comprehensive framework for project evaluation. | ![]() |


