Specialist Paediatric Continence Service
The Paediatric Continence Nurse Specialist (PCNS) service provides holistic assessment and support for children and young people age 0 – 19 years who present with complex bladder and bowel problems that have not resolved following first line assessment and intervention by the School Nurse or Health Visiting Service. This also includes children with Learning and Physical Disabilities.
The PCNS service aims to encourage and promote all children to achieve their potential with respect of continence. The service aims to reduce referrals to Secondary Care Paediatric Services and prevent unnecessary hospital admission.
The PCNS service will complete an in-depth holistic assessment of the child’s bladder and bowel problems. They will work with children and families to develop an individual treatment plan with the aim to achieve continence or if continence is not fully achievable to enable them to manage their condition more effectively.
The service offers assessment and support on all aspects of bladder and bowel management including:
- Persistent nocturnal enuresis, frequent daytime wetting, assessment and management of chronic constipation and toilet training problems where first line interventions have not been successful
- Bladder scanning
- Bladder retraining
- Self-Catheterisation
- Trans anal irrigation
- Referral to multi-disciplinary team e.g. Occupational Therapy, Physiotherapy, Dietitian
- Onward referral for specialist support from Paediatrician
- Support School Nurses, Health Visitors and Community Children’s Nurses in relation to assessment and ordering of containment products
Following assessment the PCNS may prescribe laxative medications (oral and rectal) for the treatment of constipation medication e.g. Desmopressin for nocturnal enuresis and Anticholinergic medications for children presenting with over active bladder symptoms.
Referrals
Referrals will only be accepted from GP, School Nurse, Health Visitor, Paediatric Consultants (Hospital and Community) and other Professionals for children who reside within NHSCT. Referrals will not be accepted if children and young people have not received initial advice, input and review from core Health Visiting, School Nursing and GP services.
Children requiring continence containment products will be assessed and managed by Health Visiting, School Nursing and Community Children’s Nursing Services. Referrals for children under the age of 4 who have not been diagnosed with a urological/anatomical abnormality e.g. neuropathic bladders or ano-rectal malformation will be considered following discussion with the Paediatric Continence Nurse Specialist. Referrals marked urgent cannot be prioritised.
All orders for referral should be processed through the Children’s referral service for triage.
