A better choice for women
April 1st 2009

A campaign to give females improved choice, dignity and safety in continence care is promoting the use of female urinals.Vernacare has helped develop a solution

While it is standard practice for male patients who are unable to access toilet facilities to use urinals – and devices are widely available both in hospitals and the community – the use of urinals by women is very limited.

PromoCon and Central Lancashire Primary Care Trust, which are leading the call for improved choice, say that catheterisation, bed pans and incontinence pads are the norm for immobile women in hospital.

In 2001, the Trust (then Chorley and South Ribble PCT) set up a community-based, hand-held urinal library to allow female patients an opportunity to test out the different products and find the most suitable model, before buying or being prescribed their urinal.While this was a huge step forward, the continence team recognised that to improve urinal awareness and acceptance by females and get them practised and confident in using a urinal, the campaign had to start earlier – in hospital.

This gender gap in continence care was highlighted by the Trust during a study session in April 2004.A multi-disciplinary staff group was divided in two to assess the continence needs and plan required for a male and female stroke patient, which unbeknown to them was an identical case study.While male urinals were central to the care plan for the patient identified as male, female urinals were not recommended for the female.

Part of the reason for this was the lack of a satisfactory single-use female urinal, so Julie Vickerman, clinical specialist/research occupational therapist for both Central Lancashire PCT and PromoCon,worked with medical products manufacturer Vernacare to develop a pulp urinal especially for women.

"The requirement was for a urinal that balanced stability and ease of grip with a large opening and shallow nose for patient comfort, yet was unlikely to spill,"explains Vickerman."We worked with Vernacare's product development team to arrive at a prototype that combined the best features and then set about trialling it on one of the rehabilitation wards at Chorley and South Ribble Hospital." Prototypes were also tested at other North West hospitals on general medical, stroke and rehabilitation and orthopaedic wards – resulting in the launch by Vernacare during March 2006 of a new pulp female urinal.

Despite positive feedback on the product, with 100% of female staff and patients trialled saying they would use the product again, demand for Vernacare's male urinal still outstrips the female urinal, which accounts for just 1.3% of the company's urinal sales.

Fighting for dignity

According to Vickerman the lack of take up of female urinals is a cultural and educational issue, but one worth fighting because of the benefits to patients in terms of dignity and comfort, ease of managing their own continence on leaving hospital, and safety.

"Catheters are a massive infection risk, while pads can cause skin breakdown and discomfort", says Vickerman.

"These continence care options are also inappropriate and undignified for women who may have limited mobility but retain bladder sensation and want to be independent in their toileting.

"If female patients are offered an opportunity to practice using female urinals in hospital, particularly during lengthy rehabilitation, it will help them regain bladder sensation and control and offer them more diginified, safer choices once they return to the community.

"One of the safety issues with older people is the risk of falling when getting up in the night to go to the toilet. Urinals can remove that risk and fear.

"Using female urinals in hospitals can also be a quicker and easier option to hoisting patients onto a bedpan which requires two members of staff and can cause a lot of noise and disruption during the night.

"It is imperative that nurses urgently address the discrepancy in toilet management between male and female patients and take proactive steps to give women more control and choice.This needs to start in hospitals so that female patients can better cope with the problem of bladder emptying when they return to the community." For a free sample of Vernacare's single-use female urinal call the number below.The company is happy to discuss any queries.

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