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Development of a Standardized Approach for the Assessment of Bowel and Bladder Dysfunction

Rebecca Wang1,2, Ronik Kanani3,2, Yara El Bardisi2

  • 1Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.

Pediatric Quality & Safety
|July 20, 2019
PubMed

Insights

A new standardized assessment form improves pediatric bowel and bladder dysfunction (BBD) evaluations by ensuring comprehensive history taking and screening for psychosocial concerns. This tool empowers clinicians to better manage BBD in children.

Area of Science:

  • Pediatric Urology
  • Quality Improvement Science
  • Clinical Assessment Tools

Background:

  • Bowel and bladder dysfunction (BBD) is a common pediatric condition involving lower urinary tract symptoms (LUTS) and constipation.
  • Many children with BBD present with unassessed neuropsychiatric and psychosocial issues.
  • Current assessment practices may not adequately address the complexity of BBD.

Purpose of the Study:

  • To develop and evaluate a standardized clinician assessment form for pediatric BBD.
  • To create and assess a parent-reported questionnaire for BBD evaluations.
  • To enhance the comprehensiveness of BBD assessments in pediatric care.

Main Methods:

  • A prospective quality improvement study was conducted from July 2017 to April 2018.
  • A standardized assessment form was developed using literature review and expert input.
  • Physicians used the form for new referrals, and parents completed a previsit questionnaire.

Main Results:

  • Physicians reported the form improved recall of LUTS, constipation, and psychosocial history (93%, 87%, 87%).
  • Parents felt included in care (96%) and had questions answered (100%).
  • A significant portion of parents (53%) found the previsit package difficult to complete.

Conclusions:

  • A standardized assessment form effectively guides comprehensive history taking in pediatric BBD.
  • The tool aids in screening for psychosocial risk factors, improving BBD management.
  • Implementation can empower more pediatricians to confidently evaluate and manage BBD.
Abstract

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