Children s Continence Team Enuresis Alarm Therapy for Bed Wetting

Transcription

1 Standard Operating Procedure 1 (SOP 1) Template Children s Continence Team Enuresis Alarm Therapy for Bed Wetting Why we have a procedure? (Background) Malem alarms are used when children and young people display symptoms of night time bedwetting. The Standard Operating Procedure will provide staffs with the clinical and operational management of the devices in order to deliver a safe and effective service. What overarching policy the procedure links to? The Children s Continence Team Operational Policy Trust Medical Devices Policy Which services of the trust does this apply to? Where is it in operation? This will only apply to the Children s Continence Team Group Inpatients Community Locations Mental Health Services x x all Learning Disabilities Services x x all Children and Young People Services all Who does the procedure apply to? (staff roles and responsibilities) Band 6 Nurses- To use Alarm in a safe and effective manner Band 7 Nurse -To use Alarm in a safe and effective manner Band 3 Team Administrator- To support staff with the management of Malem alarm data base. When should the procedure be applied? (Context) For the 2 nd line treatment in managing night time bedwetting for children under the age 19 years as per NICE guidance How to carry out this procedure (step step-by-step information) CCT Enuresis Alarm Therapy for Bed Wetting Page 1 of 10 Version 1.0 October 2018

2 1) Refer to the Alarm pathway Medical device pathway.vsd 2) Desirability checklist Red flags Bedwetting very infrequent (less than ½ wet beds per week) Emotional difficulties Difficulty coping with burden of bedwetting Carers expressing anger or blame Are they constipated Consideration Type of alarm Childs health needs Childs medication (i.e. are they taking medication to help them sleep) Rewards/incentives Other siblings Layout of the house Child/family motivation Daytime symptoms as well as bedwetting Secondary onset bedwetting Hearing impairments (for example, consider a vibrating alarm) Learning difficulties and/or physical disabilities 3) Issuing a new alarm to a patient Please see Enuresis alarm spreadsheet Enuresis alarm issued sheet Enuresis alarm terms of use Enuresis Alarm guidance Alarm recording sheet When an alarm becomes free to use the staff member should check the alarm spreadsheet to identify what child can be notified that an alarm is ready for collection. Parents/cares can choose to collect at their next review appointment or pick up from the Continence Team. Parents/carers have 2 weeks to collect from the team office. If they do not attend the alarm will be issued to the next patient waiting CCT Enuresis Alarm Therapy for Bed Wetting Page 2 of 10 Version 1.0 October 2018

3 4) Alarm Collection Staff nurse to add child s name to the alarm spreadsheet data base under issued alarm tab. Add Malem alarm issued sheet to the front of the patient file to help remind staff when the reviews should take place Complete Enuresis alarm terms of use with the parents/carer (or child if fraser competent) Give family alarm guidance sheet and explain how to use the alarm Give family recording charts Make families aware that they will not be offered another alarm if they misplace the alarm issued 5) Alarm Returned Move the alarm from issued alarm to return alarm tab on the spreadsheet Remove lead and discard in a clinical waste bin Remove alarm sheet and file under products/devices 6) Infection control Leads for Malem Alarms are single use items All alarms are checked before being issued for cleanliness and that they are in working order Staff nurse completed Malem alarm spreadsheet recording that the alarm is fit for use and clean 7) Ordering a new Alarm Admin order leads through the Malem Alarm website as a non-stock order under the guidance of the manager Admin to order appropriate Malem Alarm with lead as a non-stock item through their website as directed by the team manager When alarm arrives, add to the asset register and notify medical devices The medical l device team will check the alarm and add a EBME number in line with the medical device policy The device does not need yearly checking after an EBMBE number is added due to the low risk of device. The manufacturers (Malem Alarm) are contacted if the device is faulty The medical device team can condemn a device if needed and will delete from the asset register Staff nurse to update team asset register Malem batteries are discarded using the battery disposal box kept on the ground floor reception area Please see Asset register database CCT Enuresis Alarm Therapy for Bed Wetting Page 3 of 10 Version 1.0 October 2018

4 Where do I go for further advice or information? Roles and responsibilities of key staff in relation to this procedure 8) Training Eric.org.uk for family guidance and support Bedwetting under 19s- initial treatment with alarms Self-Competency medical device forms are completed yearly in line with the medical device [policy CCT Enuresis Alarm Therapy for Bed Wetting Page 4 of 10 Version 1.0 October 2018

5 Date Issued: EBME Number: Date Review: Outcome: Planned return date: Outcome: CCT Enuresis Alarm Therapy for Bed Wetting Page 5 of 10 Version 1.0 October 2018

6 Malem Enuresis Alarm It is useful to decide when you are about to use an enuresis alarm with all of your family living in the household 1) Attach the alarm to a pyjama jacket or nightdress close to the shoulder using the safety pin 2) Wear a pair of cotton pants/briefs (not boxers) next to the skin 3) Attach the sensor to the pants either using the clip on the lead or adhesive tape e.g. micropore. Position the sensor as close as possible to the area where urine is likely to be first seen on the pants. For boys this is sometimes more difficult to position due to movement. 4) Another pair of pants need to be worn over the sensor to help keep it in position 5) The alarm will sound as soon as the sensor detects any wetness. 6) When waking try to stop anymore urine from being expelled and go to the toilet to finish passing urine. 7) You can stop the sound or vibration by pressing the reset button. The sensor will need to be dried with toilet/tissue paper and re positioned using dry underwear otherwise it will keep alarming. 8) A rewarding system could encourage your child to go to the toilet at night. Agree any plan with your child before using the alarm. 9) A rewarding system could also be in place for any other children in the house as the alarm may wake them too. This may encourage other children to support their sibling. Over a period of time the child will recognise the sensation of needing to pass urine and wake up to use the toilet before any urine is passed Initially the child may not wake to the alarm and will need to be woken by a parent. If this is the case wake the child up while the alarm is still sounding so that they will get familiarise themselves to the sound and associate it with the need to wake up. The alarm should be used for at least 2 weeks after dryness is achieved The sensor can be washed in clean soapy water The alarm itself must not be immersed in water BRING THE ALARM TO EVERY APPOINTMENT Please contact the Continence service at Ridge Hill if further advice is required or replacement batteries are needed. CCT Enuresis Alarm Therapy for Bed Wetting Page 6 of 10 Version 1.0 October 2018

7 Medical devices- Terms of use Children s Continence Service The Ridge Hill Centre Brierley Hill Stourbridge DY8 5ST Equipment was issued to: Name: D.O.B: NHS number: Address Equipment Issued: EBM number: Date Issued: Malem Alarm returns date (16 weeks from date of issue): I agree to maintain the equipment and to keep it in good working order. I will bring the alarm to every review appointment. I will return the equipment to The Continence Service when the treatment is completed or it is no longer needed. I will inform The Continence Team is the equipment is broken or lost. Signature of Parent: Signature of person issuing equipment: Please note: Each Malem alarm costs the service approximately 100 to purchase. Please be mindful there is a waiting list for children to use this alarm. Not returning this alarm will have an impact on other children and cause a considerable strain on our services resources. CCT Enuresis Alarm Therapy for Bed Wetting Page 7 of 10 Version 1.0 October 2018

8 Recording sheet Day/Date Monday Time Child woke up Yes/No Alarm Triggered Size of the wet patch Small/Large Dry bed Yes/No Comments Tuesday Wednesday Thursday Friday Saturday Sunday CCT Enuresis Alarm Therapy for Bed Wetting Page 8 of 10 Version 1.0 October 2018

9 Monitoring / Review of this Procedure In the event of planned change in the process(es) described within this document or an incident involving the described process(es) within the review cycle, this SOP will be reviewed and revised as necessary to maintain its accuracy and effectiveness. Equality Impact Assessment Please refer to overarching policy Data Protection Act and Freedom of Information Act Please refer to overarching policy CCT Enuresis Alarm Therapy for Bed Wetting Page 9 of 10 Version 1.0 October 2018

10 Standard Operating Procedure Details to be completed by Corporate Governance Unique Identifier for this SOP is State if SOP is New or Revised BCPFT-CYPF-SOP-OP-1 New Policy Category Executive Director whose portfolio this SOP comes under Policy Lead/Author Job titles only Committee/Group Responsible for Approval of this SOP Month/year consultation process completed Review and Amendment History - to be completed by Corporate Governance Version Date Description of Change 1.0 Oct 2018 New SOP BCPFT Children s Services Executive Director of Nursing, AHPs, Quality and Psychology Children s Continence Lead Nurse CYPF Quality and Safety Steering Group November 2018 Month/year SOP was approved November 2018 Next review due October 2021 Disclosure Status B can be disclosed to patients and the public CCT Enuresis Alarm Therapy for Bed Wetting Page 10 of 10 Version 1.0 October 2018