The WOCN Society 40th Annual Conference (June 21-25th, 2008)
2333
Using the bladder diary as a tool to improve home care outcomes
Leigh A. Irby, BSN, RN, JD, CWOCN, Visiting Nurse Hospice Atlanta, CWOCN, 6610 Bay Circle, Suite C, Norcross, GA 30071
Urinary incontinence (UI) affects over 20 million Americans, many of whom fail to seek treatment because they consider it part of the natural aging process. To address this staggering number and erroneous mindset, UI was highlighted as a quality indicator on the Home Health Outcomes Assessment and Data Set (OASIS) which is directly linked to outcomes and reimbursement. In the past, home health clinicians largely ignored the problem and as a result, reimbursement and quality outcomes suffered because of incorrect clinical assessments and interventions. The home health CWOCNs developed an education program and clinical practice guideline using the bladder diary in concert with other data collection tools. They also served as clinical resources to the clinicians in the field. The focus of the program was to improve clinician’s assessment skills, determine the type of UI, and develop an appropriate treatment plan to improve bladder function. The bladder diary was used several times throughout the sixty day home health certification period. When UI was identified on admission, the bladder diary was used to establish a baseline for bladder function. This gives the clinician an opportunity to determine the type of UI as well as provide the patient with an opportunity to talk openly and honestly about their condition. After it is determined that the type of urinary incontinence here is reversible, and a willing caregiver is identified, the UI clinical practice guideline is followed. Midway through and at the end of the certification period as education and interventions are provided, the bladder diary is again completed for assessment and evaluation of the teaching; it also gives the patient an opportunity to see their progress. This practice innovation provides improved outcomes and treatment for many who otherwise would suffer in silence.
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See more of The WOCN Society 40th Annual Conference (June 21-25th, 2008)
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See more of The WOCN Society 40th Annual Conference (June 21-25th, 2008)