Skilled Nursing Facilities Revolutionize Care for Incontinent Residents

BladderScan^® Gets Rave Reviews from Wellspring Innovative Solutions
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The BladderScan^® is "the best thing since sliced bread," according to Mary Ann Kehoe, RN. Kehoe is the executive director of Wellspring Innovative Solutions, an alliance of eleven skilled nursing facilities in the state of Wisconsin. Out of dedication to improving resident care, Mary Ann Kehoe, Leslie Wooldridge, and the other members of team at Wellspring Innovative Solutions instituted a comprehensive incontinence program using the BladderScan^® several years ago. According to Leslie Wooldridge, a geriatric nurse practitioner and the co-owner of the Wellspring program, Wellspring was the first group to purchase BladderScan^® for use in the long-term care setting. The Wellspring BladderScan^® program was a success, and set a new standard for the care of incontinent nursing home residents.

Incontinence Reduced, Unnecessary Catheterization Eliminated

Incontinence has a profoundly negative impact on nursing home residents' quality of life, causing them shame and embarrassment. A significant amount of staff time is also required to clean up after each incontinent episode. As part of Wellspring's new program, the BladderScan^® dramatically reduced incontinence among the alliance's 1,100 residents. Kehoe explained, "In 1998, we prevented about 256,000 incontinent episodes based on gathering quarterly data on our residents who were incontinent. We know this because we compared net episodes from the year before [when the BladderScan^® had yet to be introduced]."

In the past, many Wellspring residents with bladder dysfunction were placed upon timed intermittent catheterization programs. Because the BladderScan^® noninvasively measures the amount of urine in the bladder, there is no longer any need for physicians at Wellspring facilities to order that catheterization be routinely performed at intervals of several hours. Catheterizations are performed only as needed based on actual bladder volume, as measured by the BladderScan^®. "Because of the BladderScan^®, we know when people really need to be catheterized, so people aren't catheterized on a toileting schedule anymore," said Wooldridge.

Cost Savings Realized

Wellspring realized substantial cost savings in nursing time, medication, and incontinence supplies, thanks to the BladderScan^®. By eliminating unnecessary catheterization, BladderScan^® use reduced the need for catheterization kits and for antibiotics to treat catheter-related infections. Savings in nurse aide time were perhaps the most significant for Wellspring. Wellspring administrators estimate that the new incontinence program saved nearly one million dollars throughout the alliance in nurse aide time alone. Kehoe explained, "If you take somebody in a wheelchair to the bathroom, it takes eight minutes to get them there. By contrast, if there is an incontinent episode it takes twenty-two minutes to clean and tidy up." In addition to lowering the cost of care, the reduction of incontinence leaves nursing staff with more time to deal with their residents' other needs.

Staff Satisfaction Increased

Wellspring unexpectedly discovered that BladderScan^® use improved the working conditions for nursing staff. Kehoe explained that staff members are happier when there is less incontinence. Furthermore, because the BladderScan^® is noninvasive and easy-to-use, it is a more pleasant alternative to catheterization for both staff and residents. "One great thing about the BladderScan^® is that it's user friendly," Leslie Wooldridge said. "We teach everyone to use it." Wellspring now trains all staff members who interact closely with residents on a daily basis in BladderScan^® use. Wellspring has even incorporated the BladderScan^® into a new clinical education video used to orient new employees and train staff, including not only nursing and restorative staff, but also housekeepers, nurse aides, laundry staff, and others.

Quality of Life Improved

Most importantly, the Wellspring incontinence program improved residents' daily lives. Kehoe said the BladderScan^® preserves the dignity of elderly residents by providing a noninvasive alternative to catheterization. "Catheterization is an invasion of privacy," she explained. "It causes infections and infections have to be treated with medication. It takes a lot of staff time to track a urinary tract infection. It takes a lot of supplies and documentation too." The BladderScan^® can also be used for rehabilitation and bladder retraining. Kehoe summarized some of the benefits of the BladderScan^®, which:

	Is great for biofeedback, and can help residents to retrain their bladders to hold more urine;
	Can be used during sleep so that bladder volume can be monitored without disturbing or awakening residents;
	Takes only 10 seconds to use;
	Preserves residents' dignity and improves their quality of life.

Wellspring Incontinence Program Sets New Standard of Care

The problem of incontinence is widespread. It occurs in approximately 50% of nursing home residents and is the second leading cause of institutionalization among the elderly, according to AHCPR (Agency for Health Care Policy and Research) reports. Thanks to the dedication and innovation of Kehoe, Wooldridge, and the Wellspring team, incontinence has been significantly reduced among the alliance's 1,100 residents, and the quality of life for both staff and residents has been dramatically improved. Wellspring Innovative Solutions has set the precedent for a new and higher standard of care for incontinent nursing home residents, and created a useful model for other extended care facilities.