Continence Management Program
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Medline Continence Management Program Management Continence Medline Guide User Super 2018 Incontinence Solutions Continence Management VOLUME 1 VOLUME Program Dear Valued Customer, Thank you for your dedication and commitment to Medline; we greatly value your partnership. As you know, the healthcare industry is in a state of anxiety with continued reductions in funding, and yet there is constant pressure to promote high-quality, resident-centered care. Due to changes in reimbursement, many competitors have reduced product performance to decrease the cost of absorbent disposable products. This strategy is meant to appeal to customers trying to manage cost in the wake of these reimbursement challenges. Although this strategy may appear to be effective at first glance, it fails to promote cost-effective, resident-centered care. As a leading provider of disposable incontinence supplies to the healthcare industry, Medline has continued to explore opportunities to better support you and your most pressing needs and objectives. Based on continued feedback from care providers, we have learned that management of continence can create many difficult challenges—like escalating costs and increased labor—while drastically impacting the quality of life for residents. We have also found that traditional adult disposable briefs were not designed to properly accommodate the contours of the body, leading to leakage, misuse of sizing, and poor outcomes. Medline was inspired to develop a new, innovative approach by improving and upgrading several features in our current product line. Our goal is to offer better dryness, exceptional containment, superior fit and comfort, while promoting cost-effective, individualized care and patient dignity. Today, we are proud to offer these exceptional products to you and your residents. 2 MEDLINE Table of Contents What Is Incontinence? ..............................................................................................4–5 Medline Continence Management Program ...................................................6–7 Prepare for Change ...................................................................................................8–9 Get Everyone on Board.......................................................................................10–13 Assemble a Team ..................................................................................................14–20 Designate a Champion................................................................................................21 Select a Team Captain .........................................................................................22–23 Educate the Staff..................................................................................................24–53 Educate the Family ...............................................................................................54–55 Assessment............................................................................................................ 56–68 Care Plans ....................................................................................................................... 69 Create an I.D. System ...........................................................................................70–71 Maintain and Sustain ...........................................................................................72–73 References................................................................................................................74–76 1-800-MEDLINE (633-5463) | medline.com 3 What Is Incontinence? A Widespread Issue Across Long-Term Care It’s probably no surprise that incontinence is one of the Culture Change most costly and labor-intensive issues in nursing homes First, it is important to recognize the necessity for and long-term care facilities. What’s more, despite years of improvement in both care quality and work-life quality in research and clinical efforts to improve it, the prevalence of long-term care. Acknowledge that the vital role of CNAs incontinence remains high. In fact, according to one recent in providing high-quality care, and the importance of study, upwards of 75% of residents are incontinent of urine, empowering them to improve the quality of their work feces or both.1 experience—including the effectiveness of their work—is critical. Finally, you must identify organizational culture as Another disheartening statistic is that 90% of residents a significant and necessary focus of change. become incontinent within 3 months of admission to a long-term care facility.2 A whole host of other concerns Culture change in long-term care has flourished, but accompany incontinence as well, including increased transferring culture change from programs to new risk for skin problems, a higher rate of falls, dignity and practices has been more difficult than anticipated. Many social interaction issues for residents, a greater burden organizations involved in culture-change initiatives, even on caregivers and increased costs, especially when homes with the best intentions and considerable resources, incontinence is poorly managed.3 struggle to achieve and/or sustain significant improvement in either care quality or work-life quality. Strategies for Success An important challenge to culture-change initiatives is staff turnover. In a facility with high turnover rates, As caregivers, we always want to provide the highest information is easily lost. CNAs with important, valuable quality of care possible for our residents. However, despite information may be gone when attempting to evaluate our efforts, quality issues continue to plague long-term the efforts taken toward change. To address some of the care. When we take a closer look, most of us can usually above challenges, consider: find areas for improvement. » What is it about our current continence We know that a successful implementation of a continence management protocol that allows or management program is much more likely when it is encourages these problems to continue? understood and supported across the organization. If » How can we implement a program that you have been contemplating the implementation of an supports new initiatives and integrates the organization-wide continence management program, you changes into work routines at all levels? have come to the right place. Medline knows a thing or two » How can we implement a program where on- about education and program implementation, and can help going education is built into the daily routine? you achieve your goals. Throughout the years, we have learned how important it is for CNAs to understand and feel some commitment to the desired outcomes, and to clearly understand the role they will play in achieving the outcome. This is actually much more difficult than it sounds. You have a lot of CNAs that come and go. CNAs work different shifts and are too busy to attend in-services on something they may not see as relevant to their own situation. That is why Medline has developed this comprehensive program. 4 MEDLINE What Does the Research Tell Us? » Success requires a systematic, organizational level of commitment » Continence care that is not appropriately IS INCONTINENCE? WHAT managed is often not addressed—this is partially due to caregivers and family members believing that “its just the way it has to be” » Residents and families often have a negative Tips for Success! view of incontinence and how it is being » For each resident, establish managed by facilities and staff a history of incontinence and » There are numerous barriers preventing CNAs from identify the type of incontinence. participating in the resident care they will be delivering » Implement a voiding diary » Levels of resources across facilities, such as for at least 3 days and staffing, are associated with widely varying document findings. levels of care quality and staff turnover » Develop an individualized » CNAs; perception of work-life quality is highly related care plan to promote as much to the degree of collaboration between them and their normal bladder function as direct supervisors. We also know that CNAs routinely: possible by utilizing behavioral – Feel left out of decision-making and toileting programs. (HINT: – Do not feel as if they are listened to or that their checking and changing every observations about residents are taken seriously 2 hours does not qualify as a bladder and bowel program.) CNAs want to be part of the decision-making team. They » Select the correct absorbent want their knowledge, skills, observations and insights to product based on the resident’s be considered in the residents’ care. level of incontinence. » Select the correct product size. Medline’s CMP effectively addresses these above questions » Implement a distribution by providing: system to deliver products » On-going monitoring of CNA education to the residents’ rooms. » Tools to implement the program successfully » Evaluate outcomes and » Evolving education to keep up with constant change revise individual care plans as necessary. » Clinical support to work with your CNAs Use of the Guide This guide is not a recipe for change. Any significant change must reflect the particular mission, goals, culture and internal relationships of individual organizations. As each organization has its own personality, history, commitments and challenges, this guide is intended to be used as a reference. You are encouraged to consider what it is you value in your organization and to consider how to maintain those things while engaging