Belgium is a small European country with around 10 million residents. Despite its small size, its nurses and associations are exceptionally active in promoting continence.
Public toilet initiative
Urobel, the Belgian association of urological nurses, has taken a number of initiatives. Locally, the city council of Ghent was contacted in an effort to improve the local public toilets. This led to the formation of a well-funded, city council working group on public toilets aimed at restoring, building and maintaining public sanitation. Each public building plan has to be submitted to this working group for review. More than 10 other Belgian towns and cities have followed this example.
PIRUS for patients
Several patients took the initiative to set up a national association for incontinence patients known as PIRUS (Patients with Incontinence and Retention of Urine and/or Faeces). The group evolved from the need for a patient-to-patient incontinence support group so as to give individuals peer support rather than suffering alone. PIRUS also provided them with a platform from which to lobby government and address issues related to continence care.
School sanitation project
Since continence is particularly an issue in nursery schools, Urobel initiated a school sanitation project in conjunction with a local health council. They have now developed a programme Wild on water which targets healthy food and drinking and includes drinking and toileting in school. The programme consists of a learning book for children, an educational package for teachers and parents and even has a toilet song. This programme has been implemented in all Ghent schools and will hopefully spread throughout Belgium.
Theatre play on incontinence
In order to help adults too, Urobel and PIRUS together wrote and produced a theatre play on urinary incontinence, called The Loss of Viviane. This play, with a professional director and actress, was funded by healthcare companies. It is offered free to Belgian social organisations such as women’s groups or associations for the elderly if they provide a venue seating more than 300 people. This means collaboration with other organisations and extensive advertising, thereby raising public awareness of incontinence.
Government grant for frail elderly
The frail elderly were not forgotten either. Urobel succeeded in obtaining a grant from the Belgian Health Minister to develop a guideline for urinary continence nursing in long-term care. Based on the ICI guidelines, this Belgian guideline provides nurses with tools for assessment and management with an emphasis on lifestyle changes and scheduled voiding. The guideline was presented to the Belgian parliament and courses are being given. Preparation for the first programmes for continence nursing in long-term care facilities is underway.
... and a government grant for a guideline
Finally, Urobel secured a grant from the Belgian Health Minister to develop a guideline for continence care in long-term care. Based on the International Consultation on Incontinence guideline, it provides nurses with tools for assessment and management with an emphasis on lifestyle changes and scheduled voiding. The guideline was presented in Parliament and preparation for continence nursing in long-term care facilities is now underway. Future work will involve a Belgian care pathway for the urinary incontinent with a multidisciplinary focus. Written By Ronny Pieters, Chairman Urobel.