• 2020 GAPNA Pharmacology Conference: Contemporary Pharmacology and Prescribing in Older AdultsJoin us at the 2020 GAPNA Pharmacology Conference:
    Contemporary Pharmacology and Prescribing in Older Adults

    April 14-18, 2020, Honolulu, HI.

    Earn up to 18 CNE hours.


    Find out more about it and REGISTER today!

  • 2019 Senior Report Senior Report: Older Americans have more options for home care, but still struggling.

    The United Health Foundation has released results of a sweeping new study benchmarking the health of older adults. The America's Health Rankings® Senior Report was created in partnership with GAPNA to improve the health of America's seniors.

    The data will help advanced practice nurses and other providers deliver quality care.

    Find out about it!

  • AwardNew for GAPNA members: MCM Education

    GAPNA has partnered with a MCM Education to offer an ongoing series of CNE programs available to GAPNA members. "Diagnosing and Managing Parkinson’s Disease in Older Adults," is the latest program offered.

    Parkinson’s disease (PD) is characterized by both motor and nonmotor symptoms. It is diagnosed based on the presence of two of four motor symptoms including rest tremor, bradykinesia, rigidity, and gait imbalance...

    Find out about it!

  • FREE continuing education credit is available for the following session:

    "Dementia Management Update"

    (session captured at the GAPNA 2018 Annual Conference)

    For September/October 2019 - Get Your Free CNE Now!

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.


Resources available for Urological disorders & References

Download this article.

Related Topic 1: 

GAPNA Newsletter Issue: