Newman D K
DKN & Associates, Inc., Philadelphia, Pennsylvania, USA.
Ostomy Wound Manage. 1996 Nov-Dec;42(10):46-50, 52-4, 56 passim.
The Agency for Health Care Policy and Research (AHCPR) released their first updated guideline in March, 1996. Three documents were released: the Clinical Practice Guideline, Urinary Incontinence in Adults: Acute and Chronic Management; the Quick Reference Guide, Managing Acute and Chronic Urinary Incontinence; and the Patient Guide, Understanding Incontinence. The new areas are outlined and addressed. Unlike the 1992 version, the update emphasizes the problem of urinary incontinence (UI) in a specific population, those with chronic "intractable" incontinence. It provides an algorithm in the Quick Reference Guide for selecting appropriate behavioral, pharmacologic, and surgical treatments and supportive devices for use in managing UI. The concept of "prevention" of UI and the promotion of healthy bladder habits is introduced. The updated guideline developed recommendations for each assessment and treatment method. Specific interventions that can impact individuals with chronic "intractable" incontinence are discussed including toileting assistance programs, physical and environmental alterations, fluid and dietary management, management of nighttime voiding, and other measures and supportive care. Skin care and social and organizational environmental factors are also discussed. In August, 1996 the AHCPR released two additional, original documents, the Caregiver Guide, Helping People with Incontinence, and Alert for Directors of Nursing, which are briefly discussed.
医疗保健政策与研究机构（AHCPR）于1996年3月发布了其首份更新指南。共发布了三份文件：《临床实践指南：成人尿失禁的急性和慢性管理》；《快速参考指南：急性和慢性尿失禁的管理》；以及《患者指南：了解尿失禁》。新领域得到了概述和阐述。与1992年版本不同，此次更新强调了特定人群（即患有慢性“顽固性”尿失禁的人群）的尿失禁（UI）问题。它在《快速参考指南》中提供了一种算法，用于选择合适的行为、药物和手术治疗方法以及用于管理尿失禁的支持性装置。引入了尿失禁“预防”的概念以及促进健康膀胱习惯的内容。更新后的指南针对每种评估和治疗方法制定了建议。讨论了可能影响患有慢性“顽固性”尿失禁个体的具体干预措施，包括如厕辅助计划、身体和环境改变、液体和饮食管理、夜间排尿管理以及其他措施和支持性护理。还讨论了皮肤护理以及社会和组织环境因素。1996年8月，AHCPR发布了另外两份原创文件，即《护理人员指南：帮助尿失禁患者》和《给护理主任的提醒》，将对其进行简要讨论。
