• GAPNA 2020 National President Deborah Dunn, EdD, MSN, GNP-BC, ACNS-BC, GS-C interviews Dr. Ron Billano Ordona, DNP, FNP-BC about providing home-based primary care during COVID 19.

    "Facing Forward: Providing Home-based Primary Care during COVID 19"


    View the Video

  • GAPNA 40th AnniversaryGAPNA’s anniversary theme “Preserve the Past, Enhance the Present, and Secure the Future,” reflects our shared vision for gerontological advanced practice nursing.

     

    Learn How You Can Help

  • GAPNA Exchange

       

    GAPNA Exchange is a private, secure community for members to share ideas, ask questions, lend expertise, and network with peers.

    It features both an Open Forum discussion area along with smaller, segmented communities.

    Interact with GAPNA members wherever and whenever!

    Go to GAPNA Exchange

  • CoronaCoronavirus (COVID-19) Resources

    In an effort to support our members with the most updated information on COVID-19 we developed this resource page to easily access current CDC information and other resources to assist you professionally and personally.

    We will continue to update this page with more information as it becomes available and welcome your input as we navigate through this situation. As health care professionals it is our job to educate our patients and families on prevention and the what to do if someone is symptomatic.

    View resources

     

Urological Issues in Post Acute/Long Term Care

By: Kanah May Lewallen GNP-BC, Post Acute/Long Term Care SIG (August, 2016)

Purpose: To provide the APRN with tools for the evaluation of common urological issues in the PAC/LTC patient.

While many conditions affect the quality of life for patients in post acute/long term care (PAC/LTC) not many have as significant of an impact on their quality of life as incontinence. The rate of urinary incontinence (UI) in PAC/LTC is between 46 to 76% (Centers for Disease Control and Prevention [CDC], 2014).

The evaluation and management of urological issues can be a difficult task in these complex patients, this evaluation would typically be completed by specialists in urology and/or gynecology. It is often not possible to have these patients seen by specialists leaving the APRN practicing in PAC/LTC to manage the urological issues.

In addition to the impact on the patient’s health and quality of life there are regulatory concerns driving the need for the evaluation and management of urological conditions in the PAC/LTC patient.

The Centers of Medicaid and Medicare Services have guidelines focused on the evaluation and management of incontinence in PAC/LTC (Centers for Medicare and Medicaid Services [CMS], 2011). The F-Tag 315 is the tag that focuses on UI (CMS, 2011).

With these regulations in place it is required that patients with UI be evaluated and the following algorithms can assist the APRN in the evaluation and management of urological conditions in PAC/LTC patients.

Urinary Incontience

Urinary Retention/Foley Catheters

In addition to focusing on UI F-Tag 315 includes guidelines on the use of foley catheters in the PAC/LTC setting (CMS, 2011). The regulations are very specific as to the indications that allow a Foley catheter to be used in patients in this setting.

The chart below outlines some of the regulations on foley catheters and also provides the APRN with some tools for evaluating and managing urinary retention in PAC/LTC.


References


Resources available for Urological disorders & References

Download this article.

Related Topic 1: 

GAPNA Newsletter Issue: 

VIEW ALL ARTICLES: