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.
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