Bladder & Bowel Service (BABs) Jenny Tibbs Lead Nurse Specialist Dr Rachel Bradley Consultant Physician St Martins Bladder & Bowel Service & BRI Mr Ed Courtney Consultant Colorectal Surgeon RUH
Bladder & Bowel Service (BABs) • Patient focused – Aim to improve Urinary & Faecal incontinence, distressing symptoms and QOL • To promote – Evidence based practice – NICE compliance – Innovation – Audit & research – Teaching & training of healthcare professionals
Bladder & Bowel Service (BABs) • To ensure right patient is seen by the right professional at right time – To ensure cost effectiveness – Shared multi-professional assessments • Receives referrals from 1, 2 care and patients • Current BABs pathway: SpN triage, SpN assessment & review, BDC & other specialists • Bowel Dysfunction Clinic
BABs Bowel Dysfunction Clinic • Monthly Consultant & Specialist nurse led clinic • Complex functional bowel symptoms & management advice – Aims to avoid unnecessary investigations – Clarify those that may benefit from referral to other specialists for specific treatment • Supports Continence Specialist Nurses – Case based discussion – Teaching & training
Proposed new Integrated Pathway for patients with functional Bowel Problems • However, current patient experience/journey is variable: – duplication of assessments – inconsistent approach – unnecessary investigations – QOL impact not always addressed • Greater integration & collaboration of services and clearer referral pathways will ensure improved patient experience • Raise awareness of BABs & other specialist services
Proposed new Pathway for patients with Functional Bowel Problems
Urinary pathway • There isn’t one….
Discharge Pathway for ISC
Discharge Pathway for Indwelling Catheters
Post Natal Removal of Catheters and Teaching ISC
BABs service development • CCG spec – BABs is expected to manage the prescribing of continence products and prescribe medication for over active bladder (BABs patients) • Nurses in process of completing NMP • Setting up IT system and reviewing present spend/ items prescribed by surgery • Plan – visit each surgery, meet/ review patients needs add to database. • Role out surgery by surgery commencing with ISC products
BABs service development • Access to a Women’s health physio, patients with vaginal/ rectal prolapse only [no bladder/ bowel symptoms]
BABs service development • Clinics – St Martins hospital, Paulton hospital, Keynsham health centre • Partnership working with RUH • ISC as from 10/05/16, TWOC [in the future] • Referral process – professional/ self
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