Continence Assessment

If a bladder or bowel issue is identified a holistic continence assessment should take place, by a registered nurse, based upon NICE guidance.
Use the link to learn more: - 2019

It is important that the following aspects are covered at assessment time:

An assessment should include:
• Completion of a bladder and bowel diary by the patient or carer – to include volume and types of fluids, number of voids / bowel movements and volume of urine, if possible
• A description of symptoms – bladder and bowel; duration; triggers; previous investigations
• Current coping strategies ie pads worn, urinals in use etc
• A physical examination to include observation of perineal and sacral skin, urinalysis, observation of abdomen for distension
• A bladder scan to check for residual urine
• Medication including over the counter medication
• Understanding of volume of urine or amount of stool passed if incontinence is present
• Quality of life - use a validated scoring tool eg I-QOL
• Environmental factors; access to toilet; ability to attend to own hygiene;
• Amount of urine loss either: a few drops of urine, enough urine to wet underwear and / or outerwear, complete bladder empty
• Amount of faecal leakage either: smearing, small amount of faeces or complete bowel emptying
• Cognitive ability should be reviewed to understand toilet recognition, recognition of sensation to void or empty bowels and ability to communicate this need
• Medical and Surgical History to include gynaecological and prostatic

Only nurses who have received training on continence assessment should be carrying out an assessment (UKCS minimum standards)

An assessment does take time and requires lots of questioning, listening and forming a picture of what symptoms the individual has.