I checked in with Hattie today. She tells me that she hasn’t had an “accident” in days and she’s feeling much better. She said she likes it when Sherry and the other nursing assistants offer to assist her to the bathroom and she feels more comfortable asking for assistance when she needs it. She also shared new pictures of her grandchildren. What a nice lady! I told her I’d stop by and talk with her again in a few days and that if she needed anything to please let me know.
I also checked in with Anna, the charge nurse on Hattie’s neighborhood. Anna told me that Hattie hasn’t had any incontinence episodes in the past week! Because their work reducing bladder incontinence with Hattie has gone so well, they’ve decided to work with others in the neighborhood. They identified people who are occasionally incontinent and able to ambulate. They’re in the process of completing 3 day bladder diaries to learn resident’s individual patterns.
They’ve laid out a great plan:
- Create individualized toileting schedules for each of these residents indicating what they need, such as cueing, standby assistance or hands-on assistance.
- Give information to all staff and track the resident’s bathroom times and any incontinence for a week. This will be enough data to see if they are accomplishing their goal of no incontinence episodes for each of these residents.
- Make any changes to the individualized schedules and assistance that are needed and continue to monitor.
Staff are excited. I told Anna that the team was doing a great job testing this PDSA and to let me know if she needed anything. Once this neighborhood has tested and fine-tuned the process, we’ll spread to people who are occasionally incontinent in our other neighborhoods. Once we’ve got this done, we’ll go on to figure out what we can test for those residents who are more frequently incontinent.