Study to Investigate the Efficacy of Sound Based Intervention to Improve to ilet Training Outcomes
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SESSION 2. CLINICAL PRACTICE # S2-1 (O) STUDY TO INVESTIGATE THE EFFICACY OF SOUND BASED INTERVENTION TO IMPROVE TO ILET TRAINING OUTCOMES June ROGERS Paediatric Continence, Liverpool, UNITED KINGDOM PURPOSE This study has been designed as a pilot project and has three aims, 1. To test if there is an association between a sound based intervention and toilet training progress in children with learning difficulties. 2. To explore the utility of the intervention and proposed methods of investigation in addressing the research question. 3. To inform the design of a larger randomised study. MATERIAL AND METHODS 17 children, previously resistent to toilet training interventions have been entered into the study to receive The Listening Programme intervention. The routine assessment of continence normally carried out by the paediatric continence service was used as the baseline measure for the study. For the five days per week that the children attend nursery/school they will listen to The Listening Programme of modified classical music, twice a day for fifteen minutes, for a total period of 10 weeks. Each child will listen to the music through an ‘ipod’ with a bone conduction amplifier and headphones. The children also had a Behavioural Observations Checklist completed both before and after completion of the study. Throughout the 10 weeks of the programme normal records of toilet behaviours will be kept. Both the nursery staff and parents will make normal records about toileting progress. The nursery staff will also complete a ‘listening log’ to record each child’s time spent listening to the music. At the end of the 10 week intervention the child’s continence status will be re-assessed. RESULTS Initial results are very promising with many children now cooperating with the toilet training process and a number have actually achieved continence. The full results of the study will be available to present at the conference. CONCLUSIONS Previously children resistent to toilet training were left in nappies, this intervention gives opportunities for those children to now reach their full potential. # S2-2 (O) HOSPITAL PLAY SPECIALIST (HPS) ADMINISTRATION OF ENOTONOX AS PRESCRIBED BY AN INDEPENDENT PRACTITIONER DURING URODYNAMIC URETHRAL CATHETERISATION Shirley SINNOTT and Sarah DOYLE Alder Hey NHS Foundation Trust, Urology, Liverpool, UNITED KINGDOM PURPOSE Catheterisation can be an uncomfortable and traumatic procedure for some children. HPS are in an ideal position to provide preparation and distraction for this procedure during urodynamics. Entonox is recognised as an effective treatment during uncomfortable or painful procedures (Kanagasundaram et al. Arch Dis Child 2001; 84: 492 - 495). We explore and discuss the administration and patient experience of entonox by a trained and assessed HPS during urodynamics. MATERIAL AND METHODS HPS have specialised skills to prepare, relax and support patients undergoing traumatic and painful procedures. Administration of entonox by our HPS was considered to be a unique but beneficial extended skill to complement current practice. Training was provided and assessments by competencies were undertaken by the pain specialist team under the guidance of the head of pharmacy. RESULTS Over a ten month period thirty five patients (aged 5-17 years) used entonox administered by the HPS during urodynamics. Thirty four children and young people thought that entonox helped them to relax resulting in the catheterisation experience being pain free. Thirty four children and young people reported that they would use entonox again. One patient was unable to use the entonox due to his learning difficulties which limited his mastery of the correct breathing technique when using entonox. CONCLUSIONS HPS administration of entonox for catheterisation has had a positive impact. It has improved the time efficiency and cost effectiveness of the service. The number of patients requiring general anaesthetic for catheterisation has been reduced. Most importantly positive feedback from patients has demonstrated a positive impact on quality of care. S102 ESPU Programme 2010
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Transcript of Study to Investigate the Efficacy of Sound Based Intervention to Improve to ilet Training Outcomes
S102 ESPU Programme 2010
SESSION 2. CLINICAL PRACTICE
# S2-1 (O)
STUDY TO INVESTIGATE THE EFFICACY OF SOUND BASED INTERVENTION TO IMPROVE TO ILET TRAINING OUTCOMESJune ROGERSPaediatric Continence, Liverpool, UNITED KINGDOM
PURPOSE
This study has been designed as a pilotproject and has three aims,1. To test if there is an association between
a sound based intervention and toilettraining progress in children with learningdifficulties.
2. To explore the utility of the interventionand proposed methods of investigation inaddressing the research question.
3. To inform the design of a largerrandomised study.
MATERIAL AND METHODS
17 children, previously resistent to toilettraining interventions have been enteredinto the study to receive The ListeningProgramme intervention.
The routine assessment of continencenormally carried out by the paediatriccontinence service was used as the baselinemeasure for the study.For the five days per week that the childrenattend nursery/school they will listen to TheListening Programme of modified classicalmusic, twice a day for fifteen minutes, fora total period of 10 weeks. Each child willlisten to the music through an ‘ipod’ witha bone conduction amplifier andheadphones.The children also had a BehaviouralObservations Checklist completed bothbefore and after completion of the study.Throughout the 10 weeks of the programmenormal records of toilet behaviours will bekept. Both the nursery staff and parents willmake normal records about toiletingprogress. The nursery staff will alsocomplete a ‘listening log’ to record eachchild’s time spent listening to the music.
At the end of the 10 week intervention thechild’s continence status will bere-assessed.
RESULTS
Initial results are very promising with manychildren now cooperating with the toilettraining process and a number have actuallyachieved continence.The full results of the study will be availableto present at the conference.
CONCLUSIONS
Previously children resistent to toilettraining were left in nappies, thisintervention gives opportunities for thosechildren to now reach their full potential.
# S2-2 (O)
HOSPITAL PLAY SPECIALIST (HPS) ADMINISTRATION OF ENOTONOX AS PRESCRIBED BY AN INDEPENDENTPRACTITIONER DURING URODYNAMIC URETHRAL CATHETERISATIONShirley SINNOTT and Sarah DOYLEAlder Hey NHS Foundation Trust, Urology, Liverpool, UNITED KINGDOM
PURPOSE
Catheterisation can be an uncomfortableand traumatic procedure for some children.HPS are in an ideal position to providepreparation and distraction for thisprocedure during urodynamics. Entonox isrecognised as an effective treatment duringuncomfortable or painful procedures(Kanagasundaram et al. Arch Dis Child 2001;84: 492 - 495). We explore and discuss theadministration and patient experience ofentonox by a trained and assessed HPSduring urodynamics.
MATERIAL AND METHODS
HPS have specialised skills to prepare, relaxand support patients undergoing traumatic
and painful procedures. Administration ofentonox by our HPS was considered to bea unique but beneficial extended skill tocomplement current practice. Training wasprovided and assessments by competencieswere undertaken by the pain specialist teamunder the guidance of the head of pharmacy.
RESULTS
Over a ten month period thirty five patients(aged 5-17 years) used entonox administeredby the HPS during urodynamics. Thirty fourchildren and young people thought thatentonox helped them to relax resulting inthe catheterisation experience being painfree. Thirty four children and young peoplereported that they would use entonox again.One patient was unable to use the entonox
due to his learning difficulties which limitedhis mastery of the correct breathingtechnique when using entonox.
CONCLUSIONS
HPS administration of entonox forcatheterisation has had a positive impact. Ithas improved the time efficiency and costeffectiveness of the service. The number ofpatients requiring general anaesthetic forcatheterisation has been reduced. Mostimportantly positive feedback from patientshas demonstrated a positive impact onquality of care.
