Bladder & Bowel UK Newsletter April 2019
WORLD BEDWETTING DAY Thursday 28th May 2019
BBUK SYMPOSIUM 2019 Key highlights
URINALS ON PRESCRIPTION A handy resource
NEW FACT SHEET Information on wetting alarm for toilet training
Charity number: 224742
Proud to Support the BBUK Helpline
A New Member of the BBUK Family May I introduce myself as the latest recruit to the BBUK family, as a Children's Specialist Nurse. This is the culmination of over 40 years of nursing, the last 20 being in continence roles, particularly with children with additional needs. I relish the opportunity to develop new ways of explaining the mysteries of the human body and how to better manage the poo and wee problems that occur. I love to teach, to spread the continence advice to anyone who will listen - as these messages are so basic to all our well-being.
But most of all being able to use my experience and knowledge to improve life for those children and their families, struggling with continence difficulties. Fiona Boorman Children's Specialist Nurse
Explore Our Key Features
BBUK National Symposium..........................................................................................................4 World Bedwetting Day.................................................................................................................10 New fact sheet for information on wetting alarm..........................................................................11 BBUK Just Can't Wait Cards.......................................................................................................13 Urinals on prescription.................................................................................................................14
Visit Bladder & Bowel UK's Online Shop
We are delighted to be working in partnership with Complete Care Shop to provide you with a comprehensive online shopping facility for equipment and products to make life easier. Complete Care Shop has over 250,000 in stock items at competitive prices offering you choice from a wide range of manufacturers including disposable pads, pants, urinals, bedding protection, disposal and reusable bed and chair pads, wipes, gloves and a whole lot more. The main advantage of purchasing via the Bladder & Bowel UK website, is the opportunity for you or your clients to speak to Continence Specialists for free impartial help and advice, ensuring unnecessary purchases are not made. Visit: www.bbuk.org.uk/online-shop/ or call: 0161 607 8219
BBUK National Symposium Round Up
Bladder & Bowel UK‘s Annual Symposium, continues to grow each year, providing three educational streams: Adult Bladder, Adult Bowel and Children and Young People. The Symposium enables us all to come together for valuable networking, attend clinical lectures and visit the extensive exhibition, to update on products with company representatives, charity and professional representatives.
For those of you who have never attended one of our Symposiums, the format is informal, friendly and always a buzz of activity in the exhibition hall. Delegates are able to attend any of the lectures which provide delegates with a wide range of clinical topics, research and discussion, from both local and national experts in this specialist field and with speaker’s permissions, we will share lecture slides after the event. Members of the BBUK team are on hand during the day, manning the BBUK stand and chairing the education streams. The four sessions that formed the adult bladder stream at the BBUK Symposium were very different from each other. 4
All were presented in varying styles, very well presented and all received excellent feedback. The seminar room was bulging at the seams for some of the sessions showing the popularity of the topics and speakers. Adult Bladder Sessions The morning kicked off with Dr Carmel Ramage, Consultant Urogynaecologist, who talked about Prolapse and Urinary Incontinence. The session was received very well with an overview of the service provided by Bradford Teaching Hospitals Pelvic Floor Multi-Disciplinary team as a combined approach to women and the pelvic floor.
The next session was delivered by Dr Susi Orme, Consultant Geriatrician at Barnsley. An active presentation and discussion took place around Continence in Older People with Susi sharing proactive information and positive stories about how this patient group should be assessed, managed and cared for with no exclusions purely due to age. After lunch and exhibition viewing the first afternoon session was a double act presented by Jane Spencer and James Waplington, South West Yorkshire Partnership Foundation Trust. The focus was Mental Health and Continence. The session was split between the theory of what can go wrong with an individual's mental health linked to continence followed by practical hints and tips around managing bladder, bowel and toileting issues. The link between the two subjects was identified and discussed within the group. Final session of the day was The Role of Physiotherapy in Overactive Bladder and the Use of Acupuncture, presented by Sinead McCarthy. Sinead gave an overview of continence assessment and how through assessment an overactive bladder can be identified and then defined appropriate treatment with lifestyle changes and an alternative treatment of acupuncture. Always good to hear of specialist management of bladder dysfunction.
Carole Roberts
This was a very interactive and informative session, round a subject area that can be often be difficult for people to talk about, providing an overview of the fit of psychosexual therapy with continence issues, identification of influences affecting the development and subsequent alteration of an individual's identity of “sexual-self�, factors affecting sexual function and physiological and psychological difficulties experienced by those affected by continence issues.
Adult Bowel Sessions Carole Roberts, Principal Psychosexual Therapist and Service Lead for the SHARE Service, Blackpool Teaching Hospitals NHS Foundation Trust delivered a super overview of the impact of continence issues of sexual function.
Kat Palmer
The next session was delivered by Kat Palmer, Research Fellow and Clare Molyneux, Clinical Specialist Physiotherapist in Lower GI, from Manchester University Foundation NHS Trust. 5
The session was entitled, What’s happening in Colorectal and Pelvic Floor and IBS Research. Kat provided an overview of the pelvic floor research and Clare informed delegates about current clinical studies in IBS research and how patients could be considered to enter some of the research projects examples given below.
Confident
Subsonic
Safari
CIPHER
Capacity 1
PARiS
Capacity 2
Affinity
Dietary Manipulation in IBS
Enlerosgel in treatment of IBS (D) Triton study
Capacity 3
Visceral Hypersensitivity – a role in no cardiac chest pain Tenapanor Faecal Microbial Transplant
Pelvic Floor Research at MFT The final session in the Adult Bowel care stream was delivered by Suzanne Ryder, Service Lead South Manchester Bladder and Bowel Service, Manchester University Foundation NHS Trust and this year's BBUK Bowel Award Winner, more of that later...
Polly Weston classroom
Polly Weston, Team Lead South Cumbria Continence Service University Hospital of Morecambe Bay Foundation Trust opened the afternoon session with an overview on Bowel Assessment and Treatment Pathways, discussing the differing levels of bowel assessment. Polly gave an overview of the tools that are available to aid practitioners during the assessment process, treatment pathways, alerts and bowel care procedures. As ever Polly was most entertaining with her ‘props’ that she also brought to the session to make this a mist interactive session. 6
The Children’s stream at the Symposium was every bit as busy and vibrant as the adult sessions. Dr Gabrielle Lipshen from Bolton NHS Foundation Trust delivered the first presentation, focusing on managing difficult constipation. Her session included discussion of which laxatives should be introduced if macrogols alone are ineffective or not tolerated. The second session introduced a new piece of work funded by the National Institute for Health Research (the research arm of the NHS). The purpose of the study is to scope current evidence and practice for toilet training children and young people with neurodisability.
Part of this includes a survey for affected families, educators and healthcare professionals (details of the study are available at: http://clahrcpeninsula.nihr.ac.uk/research/improvingcontinence and visit: http://sites.exeter.ac.uk/iconstudy/takingpart to sign up to take part in the survey). The afternoon sessions were started by June Rogers talking about the importance of empowering families to improve treatment outcomes for children and young people. She explained how it is not simply what the clinicians do in clinic that makes a difference to continence in children and young people; rather it is the changes they make at home, alongside adherence to suggested treatment regimes and ongoing contact with their healthcare professional. June talked about the use of social media for information, online education such as the courses provided by MindEd available at: https://mindedforfamilies.org.uk/Content/c ommon_problems_wetting_and_soiling/#/i d/5a8c13eeeb61e5ce76463e8b Web-based information such as that provided by Bladder & Bowel UK www.bbuk.org and the Stop Bedwetting site www.stopbedwetting.org to promote the right treatment choices for the individual.
As clinicians we need to be aware of appropriate options and signpost families. The final session of the day was delivered by Aisling Kiernon, from Slater and Gordon LLP and focused on the law and the children’s nurse. This thoughtprovoking session covered the requirements for proof of clinical negligence, how damages are estimated by courts when cases are found for the claimant, what the law expects of nurses and underlying legislation as well as some case studies. Overall the day was excellent, motivating and overall inspiring! A massive THANK YOU to all the speakers and delegates and exhibitors, for making the day such a success. Here’s to a great Symposium in 2020. We hope to see you all next year. We are now actively planning the Bowel Education Day on Thursday 26th September 2019 and the Paediatric Education Day on Thursday 17th October 2019. Karen Irwin Service Manager/Specalist Nurse
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Bowel Care Award Winner 2019
Awarded to - Suzanne Ryder and Team, South Manchester Bladder and Bowel Service, Manchester University Hospital Foundation NHS Trust. Background Sue has worked closely with spinal patients to ensure a smooth transition from admission to discharge and is actively involved preparing hospital staff for future spinal patient admissions. The work came about following a formal complaint meeting with a patient with spinal cord injuries and their family, where the team met with the individual, discussed their hospital experience and the huge gaps in meeting the individual's bowel care needs during a period of long admission on one of our wards. This was at a time when the July 2018 A Patient Safety Alert was released which further reinforced the service to urgently improve bowel care for spinal patients admitted across all 11 hospital sites. In preparation The team visited the North West Regional Spinal Injuries Centre at Southport, spending time learning about their bowel care and management approaches and how care is delivered. Members of the team also attended the SIA study day - Managing the Neurogenic Bowel Skills and Competency Training to further support them in their practice.
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The impacts that have been made to patient care The bladder and bowel service now deliver regular Bowel Care study days to all Trust staff, which incorporates DRE, DRF, DRS and TAI competencies for staff to complete, so they have the necessary skills to provide good quality timely bowel care procedures to spinal patients.
There is also now a growing register of RGN’s at MFT that can be contacted to support any area, in case of an urgent admission. Spinal injured patients visiting MFT are now asked to share their personal care plan. Their documents are scanned into EPR (electronic patient record) so all medical and nursing staff have immediate access to this important information, whether their admission is planned or an emergency. A ‘Personal Care Plan’ is a concise 4 page document detailing; who to contact, history, respiratory, bladder, bowel, skin, nutrition, mobility & function care needs. Patients are reassured he is knowing all these steps have been put into practice.
Future plans for practice, next steps with our project: This project has been described as innovative and well received by all three UK Spinal Units. Sue is keen that they continue to work closely with the Spinal Injuries Association (SIA) to support and encourage every spinal injured patient how to write their own ‘personal care plan’ in the UK and link them to their local acute trusts. Moving forward, Sue is keen to see more collaborative working, sharing best practice and planning a better future for patients between spinal units and acute trusts. Karen Irwin - Service Manager / Specialist Nurse
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World Bedwetting Day - Thursday 28th May
World Bedwetting Day (WBD) started in 2015 by the International Children’s Continence Society (ICCS) and the European Society for Paediatric Urology (ESPU) to raise awareness about this common medical condition. The theme focuses on ‘Time to Take Action’ as so much more can be done to diagnose and treat the condition. By raising awareness of bedwetting as a common condition that can be treated, World Bedwetting Day aims to encourage families to discuss bedwetting with their healthcare professional and get the help they need. Historically bedwetting was thought to be something that all children would ‘grow out of’. However, we now know that that is not the case. Those children with the severest form of bedwetting, i.e. wetting 3 nights per week or more, may continue to wet the bed throughout childhood and into their teens without treatment.
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As a result of the negative impact bedwetting can have on the child and family, early treatment from age 5 years is recommended. The website www.stopbedwetting.org provides information to help empower affected families seek the most appropriate advice and information. To encourage as much interest as possible in WBD, could all you tweeters out there, please follow the Twitter accounts @stop_bedwetting and @bladderboweluk June Rogers MBE Children's Specialist Nurse
Enuresis Award 2019 To highlight best practice, Bladder & Bowel UK are continuing with their national Enuresis Award. This aims to showcase an individual or team who has undertaken a piece of work resulting in the improvement in the care or support of children and young people affected by bedwetting. The winner will receive £500 plus travel and accommodation, if necessary, to attend the Children’s Education Day on Thursday 17th October in Manchester. This when they will be present their work and receive their prize. Further information and how to apply can be found at www.bbuk.org.uk/enuresis-award Download and print an application form - https://www.bbuk.org.uk/wp content/uploads/2018/10/ Enuresis-Award-2019-application-form.pdf
Fact Sheet: How to Use a Wetting Alarm for Toilet Training Following a number of enquiries from families regarding the use of a wetting alarm to enhance a toilet training programme Bladder & Bowel UK has produced a new information leaflet. This leaflet briefly explains how to use the wetting alarm, which has proven to be particularly useful for those children who struggle to not only recognise when they have passed urine, but also for those learning to respond to bladder signals appropriately and self initiate going to the toilet.
This leaflet can be freely downloaded from: www.bbuk.org.uk/wp-content/uploads/2019/04/Using-a-wetting-alarm-for-toilet-training.pdf
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Healthcare Professionals Online Learning RCGP e-Learning CPD NOCTURIA Module 2019
Nocturia is a common symptom, especially in older adults. It is commonly framed as a lower urinary tract symptom and we frequently think of a limited range of aetiologies, usually benign prostatic hypertrophy and overactive bladder. However, for many patients, nocturia is due to one or more other conditions, including endocrine causes, drug side effects and nocturnal polyuria. Nocturnal Polyuria (NP) is a prevalent condition that requires treatment. It is important that awareness and education is available to support health professionals. Diagnosis and initiation of treatment should be managed by primary care, along with support from secondary care, with management focusing on controlling nocturnal polyuria, which significantly affects an individual’s quality of life, e.g. the impact of sleep deprivation. An accredited e-learning module on Nocturia has been produced. The estimated time to complete this course is 30 minutes.
Learning objectives After the session you will be able to:Define nocturia and assess its impact on a individual Understand the range of aetiologies in nocturia and how these can overlap Use history, examination and appropriate investigations to assess a patient and diagnose with nocturia Interpret fluid/volume charts (bladder diaries) Safely prescribe medication for nocturnal polyiuria
The course is accessible to everyone with an RCGP learning account. Community Nurses who do not have an account, can register for free, using this link: 12
www.rcgp.org.uk/my-rcgp/basic-registration.aspx
BBUK Just Can't Wait Cards Although many shops and premises acknowledge the importance of the Just Can't Wait Cards, we are very aware that some don't. Recently BBUK received a tweet from somebody who was refused access to a toilet in a store, mentioned the store and received a very encouraging reply which goes to show how we can change people's attitudes.
BBUK Just Can't Wait Cards
NEW For your patients
FREE pocket sized plastic card BBUK confidential helpline Available from BBUK - a charitable service Order your supply of cards from: bladderandboweluk@disabledliving.co.uk www.bbuk.org.uk
Registered Charity No: 224742
Urinals On Prescription For further information contact: Bladder & Bowel UK Helpline: 0161 607 8219 Email: bladderandboweluk@disabledliving.co.uk The following urinals may be obtained on medical or nursing prescription Male Urinals Product
* Beambridge Funnel (range of sizes available)
Male Draining Jug
UriBag
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Image
Prescription Order Number (left to right in the photo) Mini 6 – 35 M Youth 6 – 38 Adult short 6 –37 Adult 6 – 35 (Adult & Mini are pale blue in colour)
6-50
URIbag
Urinals On Prescription Product
Image
Prescription Order Number
Payne’s male urinal bottle
1350
Beambridge Bottle Bag
6 – 80 (female adaptor available to purchase directly from Beambridge Medical Tel 01483 571928)
Female Urinals Product
* Bridge Urinal
Bridge Saddle Urinal
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Prescription Order Number
6 – 18 or 6 – 18 T (with connecting tap)
6 - 26 15
Urinals On Prescription Product
* Beambridge lady funnel
Uribag F
* Whiz
* Beambridge Lady Jug
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Image
Prescription Order Number
6.40
Manfred Sauer URIbag F
ATD 2002.1 (PIP code: 304-5554) or ATD 2004.10 (with 10cm connecting tube for use with drainage bag) (PIP code: 314-5554)
6-45
Urinals On Prescription Product
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SheWee
Prescription Order Number
Pip Code 343-0394
Unisex Urinals Product
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Prescription Order Number
* Beambridge Pod
6 - 60 6 - 6T (with connecting tap)
Uriwell
80-3360934-134
Please note: All urinals marked with a * can be attached to a drainage bag Any type of catheter drainage bag is suitable, eg leg bag, night bag 17
Urinals On Prescription Accessories to use with urinals (available on prescription) Product
Payne’s non spill adaptor (for use in standard size male urinals)
SafetyGel (liquid absorbing powder)
Vernagel (super absorbent powder)
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Prescription Order Number
1351
PIP Codes: Sachet 7g : 3859816 Shaker Pot: 3715190 1.5 kg granules: 3715208 4.5 kg granules: 3715224
Available in boxes of 100 sachets PIP Code: 322 – 9184
Loo of the Month - Wooden Shed Ecological Composting Toilet on Countryside Eco Farm
Tourist toilets at summit base camp of mount Kilimanjaro at sunset, Africa
Get in Touch with Us
For more information please visit: www.bbuk.org.uk
Bladder & Bowel UK Head Office - Disabled Living, Burrows House, 10 Priestley Road, Wardley Industrial Estate, Worsley, Manchester M28 2LY Email: bladderandboweluk@disabledliving.co.uk Tel: 0161 607 8219
Part of Disabled Living Website: www.disabledliving.co.uk Email: info@disabledliving.co.uk Tel: 0161 607 8200