Journal of Gerontological Nursing
Vol. 31 No. 12 December 2005
By Diane K. Newman, MSN, RNC, CRNP, FAAN; Theresa Gaines, RNC; Elisabeth Snare, RNC
ABSTRACT
Nursing homes are required to conduct a comprehensive assessment and screening of residents with urinary incontinence (UI) and indwelling catheter upon admission, and if there is a change in cognition, physical ability, or urinary tract function (Centers for Medicare and Medicaid Services [CMS], 2005). The desired goal is to improve the quality of care through the maintenance and the restoration of bladder function. CMS regulations and revised Tag F315 mandate that long-term care facilities appropriately assess and treat the specific bladder disorder of UI and decrease the inappropriate use of indwelling urinary catheters. Assessment includes evaluation for reversible factors that may cause UI, such as urinary retention and urinary tract infection. The scope of this article is to demonstrate the relationship between these bladder disorders and assessments that can be performed by nursing staff. Because invasive instrumentation of the bladder can increase the likelihood of urinary tract infections, the use of non-invasive technology that ensures quality and evidence-based clinical practice, while preventing associated medical problems in vulnerable residents, is necessary for bladder assessment in the extended care setting. With this technology, assessment of bladder function is easy for staff and provides information that can be vital to successful nursing care outcomes. The staff of CRISTA Senior Community changed clinical practice through incorporation of technology to determine the presence of bladder dysfunction. Staff accurately and effectively applied ultrasonography to determine the bladder volume and abnormalities with bladder emptying, with ultimate improvement in resident care. Adoption of technology can preserve the resident’s dignity and respect, while ensuring the highest level of bladder function.
ABOUT THE AUTHORS
Ms. Newman is Co-Director, Penn Center for Continence and Pelvic Health, Division of Urology, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania. She has performed consulting services for Diagnostic Ultrasound. Ms. Snare is Director of Nursing, and Ms. Gaines is Assistant Director of Nursing, CRISTA Senior Community, skilled nursing facility, Shoreline, Washington.
The authors disclose that they have no significant financial interests in any product or class of products discussed directly or indirectly in this activity, including research support.
Address correspondence to Diane K. Newman, Co-Director, Penn Center for Continence and Pelvic Health, Division of Urology, University of Pennsylvania Medical Center, 9 Penn Tower, 34th and Civic Center Boulevard, Philadelphia, PA 19104.
