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How we help patients psychologically through preparation Techniques in a Urology department.

How we help patients psychologically through preparation Techniques in a Urology department. Presented by Yvie Morley – Health Play Specialist (Nephro-Urology) & Cheryl Jennings Urology Nurse specialist. Royal Manchester Children’s Hospital. Meet the Nursing Team.

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How we help patients psychologically through preparation Techniques in a Urology department.

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  1. How we help patients psychologically through preparation Techniques in aUrology department. Presented by Yvie Morley – Health Play Specialist (Nephro-Urology) & Cheryl Jennings Urology Nurse specialist. Royal Manchester Children’s Hospital

  2. Meet the Nursing Team Sue Wright – Urology nurse specialist Janet Fishwick – head of urology specialist nursing Cheryl Jennings - Urology Nurse Specialist Bev Whitnall – Urology Nurse Specialist

  3. Urology Preparation • Bladder Augmentation • Mittrofanoff. • Removal catheters. • Bowel Management. • Urodynamics. • Bladder Neck repair. • Formation of urostomy • Bladder extrophy transition clinic. • Bladder washouts. • Bladder Assessments. • Intermittent self catheterisation.

  4. Challenges

  5. What catheterisation involves

  6. Intermittent self catheterisation • Distressing for child • Invasive procedure • Reluctance to comply • Not short term, life long

  7. Preparation for catheterisation. • Magazine • Story books/ comic book • Step by step cards • Catheter Ted • DVD • Mirror • Catheter Play • Catheterisation Diaries

  8. Catheterisation Diaries • Lots of upset children • Needed to slow the process down • Make the child feel involved in the process • Consider their feelings and thoughts • Give them hints, tips and encouragement. • Simple pictures • Step by step approach. • Gain the child’s trust

  9. Catheterisation Diary Gets the child talking about their feelings towards the procedure without feeling interrogated!

  10. A psychological approach

  11. Bladder Assessment Clinic • Nurse led clinic • Full bladder assessment • Advice on fluid intake/diet • Intensive bladder training programme • Simple explanation on how the urinary system should work. • Support for child and family. • Referral for urodynamics. • Work book to complete.

  12. Why have a work book ? • Lots of information given here and there. • Nothing that was aimed directly at the child. • Nothing that really engaged the child in the assessment. • Long and not child friendly charts to fill in. • Information that wasn’t needed. • Simple clear information that both child and family can follow. • A section for extra information/help/support • An incentive for the child to complete the programme for 2 weeks.

  13. Original bladder Diary

  14. What’s in the book ? Simple picture of the urinary system Brief explanation about section

  15. 10 years + how to train your bladder. 5-10 years reminder how to train your bladder.

  16. What drinks are good /bad for the bladder. Draw on how many drinks you had today.

  17. The good fibre guide. Poo diary!

  18. The wetting Diary Simple Key for the child to follow when filling in diary.

  19. A5 School Diary Easier to keep in bag at school attach it to main diary before clinic review.

  20. The incentive to complete the programme.

  21. Just a bit of fun

  22. Sarah’s Diary It’s really annoying me!

  23. Abigail’s comments Children engage with the programme

  24. Parents engage with the programme and work together with their child.

  25. The Results • All the children engage with the programme. • Children want to continue with sheets after initial 2 week • assessment. • Children are dry. • Decreases amount of review clinics. • Increases discharge rate from service. • Children feel involved in their treatment. • Improves self esteem and well being.

  26. Thank you for listening

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