Updated Care Plan for Incontinence

Category / Primary Body System:

Genitourinary System / Incontinence Management

Problem:

The patient is at risk for complications related to incontinence.

Goal:

The patient will not develop a urinary tract infection (UTI) for the next 90 days.

Plan/Approach:

1. Bowel and Bladder Assessment:

   • Step: Assess the patient's bowel and bladder status on admission, quarterly, and as needed.
   • Rationale: Regular assessment helps identify patterns and issues related to incontinence, enabling timely interventions.
   • Actions: Perform a comprehensive assessment of the patient's bowel and bladder function upon admission, every three months, and whenever changes occur. Document findings and update the care plan accordingly.

2. Incontinent Care Protocol:

   • Step: Provide incontinent care per house protocol.
   • Rationale: Proper incontinent care prevents skin breakdown, infection, and discomfort.
   • Actions: Follow the facility’s protocol for cleaning and caring for the skin after episodes of incontinence. Use gentle, pH-balanced cleansers and apply barrier creams as needed.

3. Use of Absorbent Products:

   • Step: Use incontinent absorbent products daily.
   • Rationale: Absorbent products help manage incontinence, keeping the skin dry and reducing the risk of infection.
   • Actions: Ensure the patient has access to appropriate absorbent products. Change products regularly to maintain skin integrity and comfort.

4. Confusion Monitoring:

   • Step: Monitor for increased confusion, noting any deviation from the patient's baseline, and report to MD/RNP.
   • Rationale: Increased confusion can be a sign of a UTI or other infection, necessitating prompt evaluation and treatment.
   • Actions: Regularly assess the patient’s cognitive status, document any changes, and report significant deviations from baseline to the healthcare provider immediately.

5. Medication Management:

   • Step: Administer medications as ordered.
   • Rationale: Appropriate medication management can help control incontinence and prevent complications.
   • Actions: Administer prescribed medications on schedule, monitor for side effects, and ensure compliance with the treatment regimen. Report any adverse reactions to the healthcare provider.

6. Urine Collection:

   • Step: Collect urine for urinalysis (UA) and culture and sensitivity (C&S) as ordered.
   • Rationale: Regular urine testing helps detect and treat UTIs early.
   • Actions: Collect urine samples as prescribed, ensure proper labeling and timely transport to the lab, and communicate results to the healthcare provider promptly.

7. Scheduled Toileting:

   • Step: Toilet the patient as scheduled.
   • Rationale: Scheduled toileting can reduce the frequency of incontinence episodes and promote bladder training.
   • Actions: Develop and follow a toileting schedule tailored to the patient’s needs, encourage the patient to use the toilet regularly, and assist as necessary.