Advances in nursing assessment and management of urinary incontinence for stroke survivors

Abstract

Urinary incontinence (UI) affects up to 60% of patients following stroke. National clinical guidelines in the UK, Australia and New Zealand recommend that people with stroke who have confirmed difficulties, once assessed, should have a continence management plan. Despite this, management is suboptimal, with less than two thirds of stroke units in the UK having a documented plan to promote continence. National clinical guidelines for stroke in the UK also recommend patients with stroke who have continued loss of bladder control 2 weeks after diagnosis should be reassessed to identify the cause of incontinence and have an ongoing treatment plan involving both patients and carers. Despite these guidelines, there is low reported use of assessment tools to screen, assess and manage UI in the acute setting, and the ongoing care and management of UI in rehabilitation and long-term care facilities is inconsistent. This review of the literature highlights the evidence base available and recommends that health professionals looking after stroke survivors should be urged to complete training and education to improve their understanding of the need for assessment and management of UI in stroke survivors for better patient care and recovery.