Challenges when working with children’s continence issues

Bobbie Jones - Continence Advisor

The referral

The referral• Name of client. D.O.B; NHI

• Parent or Guardian’s details

• Contact numbers; address

• GP

• Reason for referral

• Relevant history

• Actions taken

• Who else is involved?

Assessment

Assessors aims and

objectives

Parents aims and

objectives

Child's needs or

wants

Assessment

Getting the information

Mon Tue Wed Thur Fri Sat * Sun*

Breakfast Bowl Milo & cornflakes

2 pieces wholemeal toast with marmite & nutella

Bowl Milo & cornflakes

2 pieces wholemeal toast with marmite & nutella

Bowl Milo & cornflakes

Bowl Milo & cornflakes

2 pieces wholemeal toast with marmite & nutella

Fluids 300mls Milo 300mls Milo 300mls Milo 300mld Milo 300mls MiloMorning Tea

CruskitsCrackersgingerbread

PretzelsCrackersCruskitsTan square

PretzelsCrackersCruskitsTan square

PretzelsCrackersCruskits

PretzelsCrackersCruskitsChicken shapes

Fluids 350mls Water Lunch Tunas bun Ham bun Ham bun Ham bun Ham bun Cheese WM

toasties at friendsGingerbreadCruskitsCorn thins and cheese

Fluid 100mls 200mls L&BAfternoon tea

Corn thinsCruskits Wholegrain crackers & cheese spread

Cruskits Wholegrain crackers & peanut Brownie

Cruskits Wholegrain crackers & corn thins

Cruskits Wholegrain crackers & Tan square

Cruskits Corn thinsWholegrain crackers & Peanut Brownie

Lollies &gingerbread

Mint sliceCheddar cheese shapes

Fluids 300mls 290mls FDinner Mash pot, beans,

carrots, silver beat and chicken patties

Brown rice, mince, carrot, beans silver beat

Buritos with mince & veg

Chicken, rice, carrots, peas & beans

Pasta with carrots & peas

Potato wedges & mini pizzaHome

Pasta kidney beans & mixed veg

Fluid 100mls Back home Sips only

Total fluids I drank 750mls over the full day

I drank 750mls over the full day

I drank 750mls over the full day

I drank 750mls over the full day

I drank 750mls over the full day

Bowels BNO After school Type3-4

BNO BNO MorningType 3-4

MorningType 3-4

BNO

Saturday Drinks Urine passed Comments

10:00

12:30

13:15

16:20 40mls

19:05 35mls

20:50 50mls Before bed

Saturday Drinks Urine passed Comments

10:00

12:30 350mls At friends house

13:15 100mls Friends house

16:20 300mls 40mls Friends house

19:05 100mls 35mls

20:50 50mls Before bed

Total 850mls ?

Sunday Drinks Urine Passed Comments

8:31 100mls When I got up

11:42 90mls

13:50 200mls 50mls

15:50 70mls

16:30 140mls

16:50 100mls

18:00 150mls

19:50 60mls Before bed

Sunday Drinks Urine Passed Comments

8:31 300mls Milo 100mls When I got up

11:42 90mls

13:50 200mls Juice 50mls

15:50 70mls

16:30 290mls Fizzy 140mls

16:50 100mls

18:00 150mls

19:50 60mls Before bed

Total 790mls 760mls

Plan

• Bladder diary

• Fluid balance

• Timed toileting

• 1.2.3 do I need to pee

• Bowel diary

• Continue with ½ dose Movicol

• Review

Time Drinks Urine passed Comments

7:25 200ml O.Juice

7:50 50mls Damp pants

9:00 70mls Damp

9:40 120mls lemon

10:35 110mls Damp

12:00 150mls water

12:30 50mls Damp

13:00 100mls Damp

14:20 140mls Wet

14:30 100mls water

15:50 60mls Wet

17:10 40mls B 4 shower

17:45 200mls water

18:00 100mls lemon

18:50 115mls Wet

19:10Totals=870ml

105mls840mls+

Dry

Date Time Type stoolBSC

Large, medium, small

Pain ToiletNappypants

Medication½ dose Movicol

comments

25/9Tue

6:30pm 4 Small No Toilet Given am Wet during the day

26/9 8:10am 6 small some Toilet Very wet

Wed 4:30pm 6 Medium ? Pants Wet

5:30pm 6 Small Yes Toilet Wet

27/9 6:15pm ? ? No Toilet None Wet

28/9 8:10am 4 Small No Toilet Given Wet

29/9 12:30pm 3 Medium No Toilet None

30/9 10:30am 3/4 Large No Toilet Given

1/10 None No BM

2/10 2:00pm 4/5 Large No Toilet Given

3/10 4:30 ? ? No Toilet None

Conclusion

• Dig a little deeper.

• Obtain other notes if possible.

• Stop, reflect, reconsider.

Conclusion

Keep

It

Simple

S