Reduce Overflow Incontinence to Prevent Pressure Ulcers in Individuals with Spina Bifida

Overflow incontinence has been directly linked to the development of pressure ulcers in individuals with Spina Bifida (SB). The implementation of a bladder diary and educational session to increase awareness of pressure ulcers and decrease overflow incontinence episodes was selected. This Quality Improvement (QI) project was a quasi-experimental design with pre- /post-intervention evaluation. The setting was Camp That Love Built summer camp at Camp For All in Burton, Texas. The participants included 45 campers with SB, five to 60 years old and 16 staff members. Eligibility was dependent on necessity for intermittent catheterization and attendance of camp for the entire week. All participants received an educational session focused on pressure ulcer prevention. Campers were given a bladder diary to document catheterizations and to assist with adherence to a prescribed catheterization schedule. Staff provided verbal reminders to campers to perform catheterizations. The measurement tools included PUKAT 2.0 pre- and post-test, PUAS, and a bladder diary. PUKAT results yielded score increase more than 10% in 35 of the 61 participants. Overflow episodes recorded on the bladder diary decreased by 81% from 37 episodes on day two to seven episodes on day five. PUAS scores increased 2% from pre- to post- intervention. Educational sessions and implementation of a bladder diary decreased the episodes of urinary incontinence.