SDE: Clinical Guidelines Ch7L

Clinical Procedure Guidelines for Connecticut School NursesPrintable version | Back to Contents
7
Specialized Health Care Procedures

L. Incontinence Care

Definition

An incontinent student is one who is unable to control the passage of urine or feces (stool).

Purpose

To keep the student as clean and dry as possible; to prevent skin breakdown and subsequent infection; to improve the studentís acceptance by school peers.

Encopresis

Encopresis is one of the more frustrating disorders of middle childhood. It is the passing of stools into the underwear or pajamas far past the time of normal toilet training. Encopresis affects about 1.5 percent of young schoolchildren and can create tremendous anxiety and embarrassment for children and their families.

Encopresis is not a disease but rather a symptom of a complex relationship between the body and psychological/
environmental stresses. Boys with encopresis outnumber girls by a ratio of 6 to 1, although the reasons for this greater prevalence among males are not understood. The condition is not related to social class, family size, the childís position in the family, or the age of the parents.

(American Academy of Pediatrics. Healthychildren: Soiling (Encopresis). Retrieved on April 20, 2011.)

Equipment

Equipment will depend on the age and size of the student. With some students care can be done in a lavatory; with other students it may be necessary to use a cot with incontinence pads, basin, soap and water, disposable wash cloth and towel, plastic bag for disposal and one for soiled clothing, toilet tissue, gloves, diapers if needed, clean clothing.

Procedure

Incontinent care

  1. Remove soiled clothing;
  2. Clean studentís skin with soap and water and pat dry to avoid any irritation to the skin.
  3. Observe the studentís skin for breakdown or skin irritation.
  4. Assist student to put on clean clothing, as needed.

Delegation Considerations

Toileting and care of incontinent students is not a nursing function. Rather, toileting is considered an activity of daily living, including toileting of students with delayed achievement of this developmental task. In most cases, unless there is a specific disability that requires nursing judgment, any related service provider, including paraprofessionals, teacher, or other certified personnel can perform this task. Health aides can also perform the task, although regularly removing a student from the classroom to visit the nurseís office for this reason may not be in keeping with the studentís educational goals and objectives.

Select Nursing Considerations

  • This procedure should be done minimally twice during the school day or more frequently as determined in the individualized health care plan (IHCP).
  • Clean clothes and personal supplies are provided by the parent.
  • A bowel and bladder training program may be appropriate for this student and should be addressed in an IHCP if needed.
  • Encopresis should be considered for younger students particularly (over age 4), but also in students of any age who are incontinent.
 




Content Last Modified on 7/23/2014 1:28:08 PM