Bladder and bowel health

Formulary

The formulary and guidance document can be found in downloadable resources - Guidance For Prescribing Continence Products To Adult Patients In The Community.

We have a range of “core products” on formulary which are pre-authorised so that our nursing staff can prescribe these without additional authorisation.  

If you are a Care Home Nurse and require to prescribe a “non-core” product, please contact your local Community Nursing Team and they’ll discuss authorising the prescription with you. 

The Formulary Guidance document has lots of advice on selecting products and how to complete the PRF (product request form) and troubleshooting for when things aren’t going to plan.  Once you have assessed your patient and selected products there is an order form available to download in resources: see Ontex Highlands Care Home Order Form (pdf and Word versions).

If you are having problems please contact:

Jenny Munro
Advanced Practice Physio for Continence
email jenny.munro@nhs.scot

Assessment process

Care homes

If the resident is a residential care level resident then the local Community Nurses will undertake the assessment; as soon as you identify that the resident requires assessment (or moves in) please start a 3 day frequency volume diary and a bowel diary and request an assessment.

If the resident is in nursing care then the registered nurses in the home are responsible for the assessment. We have training available on the assessment process (see below).

Care at Home

Your client can self-refer through SPOA or the client’s GP can refer to the local Community Nurse team.

Rehabilitation

For patients where it is known or anticipated there may be difficulties with maintaining bladder and/or bowel health (e.g. learning disabilities, dementia or frailty) they must still have the opportunity for treatment before containment management options are implemented.

We offer training on Promoting Continence which focuses on lots of strategies which people don’t associate as being the traditional version of "rehabilitation" - this training is aimed at all staff.

Training

We have Assessment and Promoting Continence training that can be delivered remotely to care homes - please contact the Care Home Liaison team to discuss your needs.

Containment product training is available via the contract holder - please contact Jenny Munro or the Care Home Liaison Team for details of how to book this. It is recommended that all staff undertake this yearly to ensure that they have the most up to date knowledge and information.

Training can be arranged via your local Ontex Nurse.

Frequently asked questions

Who is responsible for the assessment?

Everyone has a role in completing frequency volume charts and bowel diaries and monitoring how the resident or client is getting on with the products but the assessment itself must be completed by a registered nurse. For a Nursing Care resident this would be the Care Home Nurse and for a Residential Care resident this would be the Community or Learning Disabilities Nurse

Do I need the products authorised?

See the guidance notes - but basically the products marked core on the Product Request Form (PRF) are pre-authorised but non-core products need authorised by an authoriser, either from the LD team, Community Nursing Team or Jenny Munro.

The product doesn’t seem to be meeting my resident’s needs, what should I do?

• rule out any issues such as a UTI
• check that the product is being fitted correctly
• repeat a frequency volume chart (FVC) and ensure correct fluid intake

How often should I reassess my patient?

As often as they need; this may be once every six months, in a resident whose symptoms are stable, to ensure that the product continues to meet their needs and be sure that there are no skin issues. In a resident whose condition or symptoms are changing rapidly then more frequent re-assessment will be required.

What training is available?

Product training is available from the pad provider and it’s recommended that every member of staff attends this every year to ensure that they are up to date and able to troubleshoot.

The Care Home Liaison Team and Continence Practitioner have Assessment and Promoting Continence sessions that are delivered remotely. Visits to your facility can be arranged as required.

Catheter care

Catheter care for care workers (pdf)

To download and print additional catheter passports if you need them, use either of these links:

• Urinary catheter care passport (pdf, October 2017)
• Urinary Catheter Care Passport from Public Health Scotland

Useful links

• Guidance on urinary tract infections (UTIs) from Scottish Antimicrobial Prescribing Group (SAPG)
• Bristol Stool Chart from NICE
• Wound Management Guidelines and Formulary from Treatments and Medicines (TAM) - tissue viability formulary
• Pressure ulcer grading and excoriation tool from Healthcare Improvement Scotland