Continence Assessment Form And Care Plan (Page 5 of 7) in pdf

SECTION C: Nutrition (fluid & diet)

Best practice recommendations

Aim for the resident to have 5-10 cups of fluid per day unless otherwise indicated & limit known bladder irritants (i.e. coffee, alcohol)

■

Aim for the resident to have 30gm of dietary fibre per day unless otherwise indicated

■

Assessment Cues

Care Options

(tick appropriate care option)

(tick appropriate response)

20. Does the resident drink an adequate

If sometimes or no:

amount of fluid to maintain hydration

■

Encourage resident to drink _________ cups of ______________ per day.

and healthy bladder and bowel function?

■

Monitor and report underhydration (under 5 cups per day & dark coloured urine).

(Refer to 3-day bladder chart and check

colour of urine)

■

Monitor and report excessive drinking (over 10 cups per day).

■

Yes

■

Monitor urine colour (if concerned about dehydration).

■

Sometimes

■

21. Does the resident eat an adequate

If sometimes or no:

amount of food with fibrous content

■

Refer to resident’s nutritional care plan.

to maintain healthy bladder and

■

Encourage the resident to eat cereals, vegetables and fruit regularly.

bowel function? (Refer to nutritional

assessment)

■

Offer small snacks regularly.

■

Yes

■

Refer to nutritional/swallowing assessment and care plan.

■

Sometimes

■

Ensure dentures are in at meal times and that they fit.

SECTION D: Skin care

Best practice recommendations

Aim for the resident’s skin to remain intact and free from rashes, excoriation and pressure ulcers

■

Assessment Cues

Care Options

(tick appropriate care option)

(tick appropriate response)

22. Does the resident’s skin around

If yes to any skin abnormalities, consider the general care options below and

their buttocks, groin and perineal area

ask the RN, Continence Nurse and/or GP about the care required.

appear to:

■

Change wet pads, linen and clothing soon after incontinent episodes.

■

Be very thin or fragile

■

Use the wetness indicators on disposable continence pads as a guide to know when to change

■

Be reddened

the pad.

■

Be unusually pale

■

Use a non- irritating, pH neutral product for washing the skin after each incontinent episode.

Have a discharge

■

Have a foul or bad smell

Use a soft toilet paper or ‘wet ones’ for wiping if skin is very sensitive.

■

Be broken, have a rash or have

■

Apply a barrier cream for protection against exposure to urine and/or faeces

lumps and blotches

■

Other (specify) _____________

____________________________

23. Is the resident currently using a

If yes, select a

Select from the following options:

continence product to contain their

product that is

Day

Night

incontinence?

able to absorb

■

Disposable pad

(type) ____________

(type) _____________

the volume of

Yes – during day and night

■

urine loss and/

■

Yes – during day only

Washable pad/pant

(type) ____________

(type) ______________

or contain the

■

Yes – during night only

■

Commode

faecal matter and

■

is comfortable for

■

Condom drainage

the resident.

Developed by Deakin University and funded under the National Continence Management Strategy

Continence Assessment Form And Care Plan Page 5

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