Section O: RN - Continence

Bladder Continence

Intent:

To determine and record the person's pattern of bladder continence (control) over the last 3 days.

 

Definition:

This item describes the person’s bladder incontinence pattern taking into account any control plans or devices, such as scheduled toileting plans, continence training programs, or urinary appliances.  It does not refer to the person's ability to toilet him - or herself - e.g., a person can receive extensive assistance in toileting and be continent.  Bladder incontinence includes any level of dribbling or wetting of urine.

 

Process:

Review the person’s urinary elimination pattern with him or her.  Make sure that your discussions are held in private.  Control of bladder function is a sensitive subject, particularly for persons who are struggling to maintain control.  Many people with poor control will try to hide their problems out of embarrassment or fear of retribution or institutionalization.  Others will not report problems because they mistakenly believe that incontinence is a natural part of aging and that nothing can be done to reverse the problem.  Despite these common reactions to incontinence, many people are relieved when a health care professional shows enough concern to ask about the nature of the problem in a sensitive, straightforward manner.

 

 

Coding:

A six-level coding scale is used to describe continence patterns.  Choose one response to code the person’s level of urinary continence over the last 3 days.

 

Code for the actual bladder continence pattern with urinary device if used. This pattern is the frequency with which the person is wet during the 3-day assessment period.  Do not record the level of control that the person might have had under optimal circumstances (e.g., had a caregiver been available 24 hours/day to help the person with toileting).  

 

For bladder incontinence, the difference between a code of (Frequently Incontinent) and  (Incontinent) is determined by the presence (frequently incontinent) or absence (incontinent) of any bladder control.

 

Examples of Bladder Continence Coding