Improving patients' bladder and bowel dysfunction assessments

In 2021/2022, the Newcastle Specialist Continence Service embarked on a quality improvement (QI) project, the Bladder and Bowel Assessment Project (BBAP). The project's underpinning aim was to improve and increase the assessment and treatment of bladder and bowel dysfunction, while reducing reliance on containment products. National guidance tells us that we must attempt curative treatment for bladder and/or bowel dysfunction, before offering containment to patients (NHS England, 2018). Historically, some patients had not received a full holistic assessment, a diagnosis or a treatment plan for their bladder and bowel dysfunction. Instead, they received a containment product, which can then lead to psychological dependence (Department of Health, 2018)

The Newcastle Specialist Continence Service consisted of a small team of one community specialist nurse and one acute nurse consultant. To enable the project, a second nurse specialist was appointed to the service on secondment in 2020. The QI project began amid the COVID-19 pandemic. This came with some challenges. Backhouse and Ogunlayi (2020) stated that leading and embedding QI changes can be a challenging, complex process, requiring a multifaceted approach. At this time, staff at the Newcastle upon Tyne NHS Foundation Trust were under tremendous pressure, often working with reduced staffing due to colleagues having to isolate, a shift in priorities of work and little opportunity to engage with training. Despite the challenges, the project has still been extremely successful.