Implementing and sustaining evidence-based practices in long-term care.

Continence and Contispation

The following resource is designed to assist Long-Term Care (LTC) homes with the implementation of the following Best Practice Gudielines:

  • Promoting Continence Using Prompted Voiding
  • Prevention of Constipation in the Older Adult Population 
  • Ostomy Care and Management

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 Program team. Visit this site often to see what's new!

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Transdisciplinary Patient/Client Continence Assessment Tool - RNAO

A detailed, 8 page assessment of urinary and bowel continence issues that can be completed by a staff. Treatment options are suggested and a client record sheet is included.

Reference: Registered Nurses’ Association of Ontario (2006). Transdisciplinary Patient/Client Continence Assessment Tool. Toronto, Canada: Registered Nurses’ Association of Ontario. Retrieved from: http://ltctoolkit.rnao.ca/sites/default/files/resources/continence/Continence_AssessmentTools/RNAO_TransdisciplinaryPatientClient_Continence.pdf

Guideline for Prevention of Catheter-Associated Urinary Tract Infections

A best practice guideline on preventing Catheter-associated Urinary Tract Infections. For use by infection prevention staff, administrators, nurses, and other healthcare providers across the continuum of care. Developed by the Centre for Disease Control and Prevention.

Reference: Healthcare Infection Control Practices Advisory Committee (HICPAC) and Centre for Disease Control and Prevention. (CDC). 2009. Guideline for Prevention of Catheter-associated Urinary Tract Infections. http://www.cdc.gov/hicpac/pdf/CAUTI/CAUTIguideline2009final.pdf.

Catheterisation Urethral Intermittent in adults - Evidence-based Guidelines for Best Practice in Urological Health Care in Europe

This guideline has illustrations and procedures on how to do intermittent catheterizations in adult.

Reference: Vahr, S. Cobussen-Boekhorst, H, Eikenboom, J, Geng, V, Holroyd, S, Lester, M, Pearce, I and Vandewinke, C. 2013. Evidence-based Guidelines for Best Practice in Urological Health Care Catheterisation Dilatation, urethral intermittent in adults. European Association of Urology Nurses. http://nurses.uroweb.org/wp-content/uploads/2013_EAUN_Guideline_Milan_2013-Lr_DEF.pdf.
 

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UTI Program (PHO) - When to Collect a Urine Specimen for Culture and Sensitivity

This Public Health Ontario resource provides a list of UTI symptoms, contrasts between non-catheterized and catheterized residents and when not to send a specimen.

Reference: Public Health Ontario, 2014, When To Collect A Urine Specimen For Culture And Sensitivity Fact Sheet. Retrieved from https://www.publichealthontario.ca/-/media/Documents/U/2016/uti-urine-co...

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UTI Program (PHO) - Frequently Asked Questions for Residents and Families

This resource can be used by health care providers at the long-term care homes (LTCHs) when consulting or meeting with friends and families of residents who have questions about a LTCH’s approach to managing suspected UTIs.

Reference: Public Health Ontario (PHO). Revised 2016. Retrieved from https://www.publichealthontario.ca/-/media/Documents/U/2016/uti-faq-resi...

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Incontinence - Associated Dermatitis Intervention Tool (IADIT)

This IADIT tool is an excellent resource on skin care for incontinent people. It has clear pictures, definitions and short descriptions of skin changes and rashes.

Copyright © 2008 Joan Junkin. All rights reserved. Please send request for permissions to IADIT@medbiopub.com.  

1. Bliss DZ, Zehrer C, Savik K, et al. Incontinence-associated skin damage in nursing home residents: a secondary analysis of a prospective, multicenter study. Ostomy Wound Manage. 2006;52:46–55.

2. Institute for Healthcare Improvement. Prevent Pressure Ulcers: How-To Guide. May 2007. Available at: http://www.ihi.org/nr/rdonlyres/5ababb51-93b3-4d88-ae19- be88b7d96858/0/pressureulcerhowtoguide.doc  

3. Gray M, Bliss DB, Ermer-Seltun J, et al. Incontinence-associated dermatitis: a consensus. J Wound Ostomy Continence Nurs. 2007;34:45-54.

4. Junkin J, Selekof JL. Prevalence of incontinence and associated skin injury in the acute care inpatient. J Wound Ostomy Continence Nurs. 2007;34:260-269.

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