Creative staff training about urinary incontinence

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Sherri Mathis
Sherri Mathis
Issues around urinary incontinence (UI) are challenging for nursing home staff members who provide emotional and physical care to residents. The rate of urinary incontinence is estimated at between 45% and 70% for residents in long-term care (LTC) settings.

A knowledge gap exists among nursing home staff members in the areas of attitude toward UI, types of UI, and assessment of UI. To reduce the existing knowledge gap, an interdisciplinary research team from the University of Southern Indiana created an evidence-based UI education program titled Bladder Buzz staff. 

The purpose of the Bladder Buzz program is to dispel myths about UI, improve knowledge about the types of UI, and to begin to build assessments skills related to UI among care setting staff. Bladder Buzz is a seven-week program designed for long-term care setting staff members who provide emotional and physical support to residents. This group of staff includes certified nurses' assistants, licensed nurses, registered nurses, occupational therapists, physical therapists, social workers, activity professionals, and other staff as appropriate.

The Bladder Buzz program begins with an opening in-service. The in-service is based on an emotive case study that discusses emotional and physiological issues related to UI that residents may encounter when they move into a care setting. The emotive case study is a fictional story, but it is built on direct responses that residents have provided to the research team in a previous research project (indicated in italics below). The elder featured in the case study is named Mrs. Kingsley. In the case study, Mrs. Kingsley does not want to ask too many questions of the staff on her first night in the care setting.  Mrs. Kingsley wanted to talk about her UI, but the staff seemed rushed. When alone in her room, Mrs. Kingsley cried softly.  A series of case study questions are posed to staff members in small groups and are intended to become more complex as the case study evolves. Examples of case study questions include:

1)   How do you handle urinary incontinence with new residents who move into your care setting?

2)   How can you improve dialog with residents on the topic of urinary incontinence?

3)   Based on what you know from the story, what types of incontinence could Mrs. Kingley have?

4)   What type of toileting program could you suggest in order to help Mrs. Kingsley?

5)   How would a toileting program impact Mrs. Kingsley quality of life?

6)   How would a toileting program for Mrs. Kingsley impact your quality of life as a caregiver?

After the first in-service in week one, evidence-based educational handouts related to UI are distributed to staff over the next six weeks.  A mnemonic, dubbed SUMO Fun, was developed in order to aid staff memory on the types of UI.  Educational handouts include posters, handouts, buttons, cue cards and table tents highlighting types of UI, management and treatment of UI, and assessment of UI. 

Finally, as the culminating in-service, an evidenced-based Bladder Buzz Jeopardy game was developed to engage staff and promote learning in a fun and interactive manner. The Bladder Buzz Jeopardy game categories include: types of UI, bladder dysfunction, case scenarios, and treatment. 

The Bladder Buzz program has been tested in six Midwest nursing homes and preliminary results indicate significantly improved knowledge about UI among nursing home staff.  Providing nursing home administrators and staff educators with tools to improve knowledge about UI can potentially reduce the number of UI episodes residents experience, improve residents' health related quality of life, and improve nursing home quality. To access Bladder Buzz material for your staff, visit http://health.usi.edu/CHAW/bbabout.asp

Katie Ehlman, Ph.D., LNHA, CHES, is the director of Center for Healthy Aging and Wellness and an assistant professor of gerontology. College of Nursing and Health Professions at the University of Southern Indiana. Sherri Mathis, DOT, OTR/L is an assistant professor OT/OTA Programs, College of Nursing and Health Professions, University of Southern Indiana. B. Renée Dugger, DNP, RN, GCNS-BC is an associate professor in the Department of Nursing, University of South Carolina Beaufort.

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