Module 6: Review

In this section, we review practice recommendations for the urinary continence care of stroke survivors. In previous sections, we have explored assessment, urinary incontinence management, urinary retention management, and general continence management recommendations. These recommendations are summarized below:

Urinary Continence Assessment Recommendations

1.1 Assess the Stroke Survivors Continence History

1.2 Obtain the Stroke Survivor’s Baseline Postvoid Residual Volume and Voiding Patterns

1.3 Contributing Factors to Urinary Continence Challenges, such as Functional Abilities, Aphasia, Changes in Diet, and Consumption of Bladder Irritants

1.4 Discuss Knowledge, Goals, Beliefs and Attitudes Toward Urinary Continence with the Stroke Survivor

1.5 Assess the Stroke Survivor for the Presence of Urinary Tract Infections

1.6 Assess the Stroke Survivor for Constipation

1.7 Identify Environmental Barriers to Successful Toileting for the Stroke Survivor

1.8 Identify Type of Incontinence Experienced by the Stroke Survivor

Urinary Incontinence Management Recommendations

2.1 Assess Type and Severity of Urinary Incontinence Using a Validated Assessment Tool

2.2 Manage Urinary Incontinence Using Prompted Voiding for Stroke Survivors with Physical and Mild Cognitive Impairments

2.3 Manage Urinary Incontinence Using Timed Voiding for Stroke Survivors with Severe Cognitive Impairments

2.4 Use Urinary Continence Management Products According to the Needs and Preferences of the Stroke Survivor

Urinary Retention Management Recommendations

3.1 Ensure Optimal Patient Positioning for Voiding (Sitting for Women; Sitting or Standing for Men) According to the Stroke Survivor’s Preferences and Abilities

3.2 Use Intermittent Catheterization to Manage the Stroke Survivor’s Urinary Retention

3.3 Use the Smallest Possible Catheter Size to Minimize Discomfort (10-12F for Women; 14F for Men)

General Continence Care Recommendations

4.1 Implement a Bowel Management Protocol, if Necessary, and Promote Health Intake of Fluid

4.2 Promote Privacy While Toileting, When Possible, to Maintain the Stroke Survivor’s Dignity

4.3 Consult with the Medical Team if the Stroke Survivor has Complex Continence Care Needs that Cannot be Managed or Resolved Using the Preceding Recommendations

Conclusion

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