EMAP



Female pelvic floor 2: assessment and rehabilitationYates A (2019) Female pelvic floor 2: assessment and rehabilitation. Nursing Times [online]; 115: 6, 30-33. How to use this article for your journal club discussionPrint and read the article before your journal club meeting, and use the author commentary and discussion points below to help get your discussions started. Participation in journal clubs can be used for revalidation as:Participatory CPD: describe what you have learnt and how you will apply it to your practice, and how it links to the NMC Code;Reflective accounts: think about what you learned from your discussions, how you can use your learning to improve your practice, and how this relates to the NMC Code.If you subscribe to Nursing Times, log the evidence in the ‘Other professional development’ or ‘Reflective accounts’ section of your NT Portfolio.Author commentary: pelvic floor muscles are too often forgottenThe pelvic floor is a complex group of muscles present in both men and women, but these muscles, although vital, are often forgotten about and neglected. Many women are not aware of where they are, what they do and how they work, until something goes wrong – for example, when they develop pelvic organ prolapse or bladder and/or bowel incontinence as a consequence of a weakened pelvic floor. A weakened pelvic floor can be treated with rehabilitation exercises, but most pelvic floor issues can also be prevented by improving patients’ education and awareness, helping them to identify and reduce risk factors. The functions of the pelvic floor are many and include supporting the pelvic organs, providing stability to the spine, helping with continence (especially when sneezing or coughing and on exertion), helping with sexual function, and facilitating birth. Women are at significant risk of pelvic floor dysfunction due to their anatomy, to pregnancy and childbirth, and to the menopause. The NHS long-term plan notes that, after childbirth, one in three women will have urinary incontinence, one in 10 faecal incontinence and one in 12 pelvic organ prolapse. The NHS recommends pelvic floor exercises as the most cost-effective intervention for preventing and treating mild-to-moderate incontinence and prolapse. Therefore, it is imperative that health professionals are aware of pelvic floor health, have knowledge of pelvic floor anatomy and function, have the competence to assess it and the skills to recommend an exercise programme. When teaching pelvic floor exercises to patients, it is useful to dispel some of the misconceptions around the topic, such as ‘I’m too old to do the exercises’, ‘I can’t sit on the floor to do them’, ‘I’ve already had my baby so the damage is done’ or ‘I can teach myself, as the exercises are easy to do’…Equipped with a solid understanding of the pelvic floor, sound knowledge of risk factors for pelvic floor dysfunction and the skills to teach a basic rehabilitation programme, nurses can help women look after their pelvic floor and keep the incontinence statistics from rising. Author: Ann Yates is director of continence services, Cardiff and Vale University Health Board.Discussion pointsAre you aware of the risk factors for, and causes of, pelvic floor muscles weakness?How can health professionals safely and appropriately conduct intimate examinations?How would you convince patients that pelvic floor exercises are worth the effort?How do you, as a health professional, engage with women to promote pelvic floor health and preventive or rehabilitative exercises?What is the role of health professionals in relation to the wider prevention of pelvic floor dysfunction?Female pelvic floor 2: assessment and rehabilitationYates A (2019) Female pelvic floor 2: assessment and rehabilitation. Nursing Times [online]; 115: 6, 30-33. -63500165735Revalidation evidenceMake a note of how your journal club discussion relates to your own practice and the NMC Code, what you learnt from reading and discussing the article and how you will use this learning to change your practice. If you subscribe to Nursing Times, you can upload this article with your notes into your NT Portfolio as evidence of participatory CPD. You can also use it as the basis for a reflective account.0Revalidation evidenceMake a note of how your journal club discussion relates to your own practice and the NMC Code, what you learnt from reading and discussing the article and how you will use this learning to change your practice. If you subscribe to Nursing Times, you can upload this article with your notes into your NT Portfolio as evidence of participatory CPD. You can also use it as the basis for a reflective account.Your notes ................
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