Faecal incontinence is an impaired ability to control the passage of stool, often described as involuntary loss of solid or liquid stool, and the symptom of an underlying diagnosis. It is a common problem in older adults. Although not a life-threatening condition, it can have a significant negative effect on an individual’s quality of life and adverse medical, social and economic consequences. Due to the taboo and stigmatising nature of the condition many individuals do not seek assistance. Healthcare professionals should take every opportunity to ask about faecal incontinence symptoms so that symptomatic relief and treatment interventions can be initiated. There are several conservative approaches available for the treatment of faecal incontinence, which should be considered as first line to target symptomatic relief.
To understand the aspects of assessment and investigations used to diagnose urinary tract infections (UTIs) in men
To update your knowledge of effective treatment and prevention strategies for UTIs in men
To count towards revalidation as part of your 35 hours of CPD, or you may wish to write a reflective account (UK readers)
To contribute towards your professional development and local registration renewal requirements (non-UK readers)
While urinary tract infections (UTIs) are uncommon in healthy men aged under 50 years, their prevalence rises in men aged over 65 years. UTIs can be classified as uncomplicated or complicated. UTI in men is considered to be more complicated than in women, because it is often related to abnormalities of the urinary tract, such as prostatic enlargement or a urethral stricture. UTI is associated with a significant disease burden and cost to patients and healthcare organisations. It is one of the most common reasons for prescription of antibiotics in primary care; however, because antibiotic resistance is becoming increasingly widespread, it is essential that these drugs are used prudently. The main strategy for preventing UTIs in men is to avoid the use of indwelling catheters.
Urinary tract infections (UTIs) are common in older people, with the prevalence increasing with age in both sexes. UTI is a frequent reason for emergency admission to hospital. There are many conditions that contribute to older people being more at risk of UTI and the main preventive strategy is to avoid the use of indwelling urethral catheters. Where an indwelling catheter is inserted its continued use should be regularly reviewed and the catheter removed, especially if the reason for insertion is incontinence and the person becomes additionally incontinent of faeces.
Diagnosis of UTI can be complex because older people do not always exhibit the signs and symptoms commonly associated with UTI. Diagnosis can be further complicated by a person’s inability to provide a comprehensive history and by difficulties obtaining an uncontaminated, ‘clean catch’ urine specimen. Antibiotic therapy should not be used routinely for people with asymptomatic bacteriuria and, where antibiotics are required, healthcare professionals should follow local prescribing guidelines.
This article aims to assist nurses to undertake the removal of an indwelling urinary catheter in female patients in a safe, timely, effective and patient-centred manner, while maintaining the patient’s privacy and dignity. It is important for the nurse to be competent in undertaking this procedure, and to be aware of local and national policies on catheter removal.
Indwelling urinary catheters should be changed only when clinically necessary, or according to the manufacturer’s guidelines.
Urinary catheters should be removed using sterile equipment.
The balloon of the indwelling catheter must be deflated before removal, and the catheter should be removed slowly to minimise trauma.
‘How to’ articles can help you update your practice and ensure it remains evidence-based. Apply this article to your practice. Reflect on and write a short account of:
How you think this article might change your practice when removing an indwelling urinary catheter.
How you could use this article to educate your colleagues.