Delivering Excellence in Lifelong Learning
Female nurse holding a tablet and talking with a male patient Female nurse holding a tablet and talking with a male patient

Nursing Concepts in Continence Care

Learn best practices in continence care

A collaborative program involving the School of Nursing and McMaster Continuing Education.

NRS 102 - Advanced Concepts in Continence Care C21

Academic Credit Value:
3 units
Course Delivery Mode:
Hours of Study:
39 hours
Course Prerequisite(s):
Course Anti-requisite(s):
Instructor Name:
Jennifer Skelly
Course Dates:
09/20/2021 - 11/28/2021

Required Course Materials:
(1) Doughty, D.B. (2006). Urinary and faecal incontinence: Nursing management (3rd Edition). Toronto: Mosby Publishers. (2) Gartley, C.B., Klein, M.R., Norton, C., & Saltmarche, A. (Eds.). (2011). Managing life with incontinence. Wilmette, IL: The Simon Foundation.(3) Cowie, B., Northwood, M., Robbs, L., Hunter, K. F., Sebastian, S., & Fisher, P. (2014). P. Eyles (Ed.), Promoting Continence Care, A Bladder and Bowel Handbook for Care Providers. Hamilton: McMaster University Press.
Optional Course Materials:
Course Description:

Students are advised to retain course outlines for future use in support of applications for employment or transfer of credits.

Refer to the Policy & Procedure section for further course and McMaster Continuing Education information. 

Advanced Concepts in Continence Care is an online course which builds on the introductory course NRS 101 Nursing Concepts in Continence Care. It integrates asynchronous learning modules and discussion boards as well as synchronous online tutorials which will focus on specific bladder and bowel incontinence issues that require specialized knowledge and management strategies. This will further expand students’ understanding about the role that nursing can play in assessment, management as well as patient and staff education.  Selected problem based clinical cases will be explored through online, interactive, multimedia learning modules. Online tutorial sessions will provide students with opportunities to discuss their assessments, identify contributing factors and consider treatment recommendations. Discussion Boards will also be utilized to provide students with the opportunity to interact.

This course provides students with the opportunity to understand specific bladder and bowel issues that can arise related to underlying medical issues such as spinal cord injury, acquired brain injury, and multiple sclerosis. Understanding the factors that can contribute to complex bladder and bowel incontinence is essential in developing effective management strategies. This knowledge is essential when developing patient and staff educational materials.

Learning Outcomes:

Upon completion of this course, students will be able to:

•       Integrate knowledge of underlying medical conditions that can contribute to incontinence into clinical reasoning and nursing judgments that inform, and guide assessment and management related to bladder and bowel care.

•       To provide a holistic approach to the assessment of bladder and bowel incontinence which results in identifying factors that may be contributing and developing appropriate nursing interventions.

•       To build on an in-depth knowledge of the behavioral and educational interventions used in management of incontinence. Integrate nursing research (evidence-informed decision-making) as the basis of practice where applicable. Provide rationale for nursing-specific interventions using scientific knowledge.

•       Understanding the impact of incontinence on the client's and caregiver’s well-being and quality of life.

Course Evaluation

The final grade is calculated based on the following components:

Online Quizzes (5) 25%
Tutorial/Discussion Board Participation 25%
1st Clinical Case Study 20%.
2nd Final Clinical Case Study 20%.
Presentation of Patient or Staff Teaching Strategy to Tutorial Group 10%
Course Format:
The course will include 8 online multi-media modules, 6 ninety-minute synchronous tutorials using Zoom, and asynchronous discussion board groups to encourage student engagement with class materials online.   Integrative ninety-minute online evening tutorials will be held throughout the term.  Schedule is posted at the end of the course outline. Discussion Board topics will be posted one every 2 weeks throughout the term. Assessment will include 3 online quizzes throughout the term, 2 in-depth clinical case studies one midterm and the other at the end of term and tutorial / discussion board participation.

In each learning module clinical cases will be used to explore different types of urinary and fecal incontinence using online, interactive, multimedia learning modules. Online tutorial sessions will be used to consolidate the students learning and provide opportunities to present their assessments of the clinical case, identified contributing factors, management and educational strategies.

These learning activities will aid students in developing a deeper personal knowing of the relationship between scientific knowledge and evidence-based nursing practice.

A. Continence Care Learning Modules (8 online modules)

Students will engage in a series of learning modules that discuss a variety of advanced concepts related to bladder and bowel incontinence. Clinical case scenarios will be used to enhance the student’s ability to assess, identify contributing factors and develop nursing treatment plans and educational strategies available.

These learning modules incorporate text, images, animation, video and audio to provide students with a multi-modal learning experience. Relevant links to journal articles, best practice guidelines and clinically relevant webpages may also be included as learning supplements in the Attachments section of each module.

B. Synchronous Integrative Online Tutorials (6, 90-minute tutorials)

Prior to each integrative tutorial session, students are expected to view the relevant learning module (accessible through Avenue to Learn) and complete all required readings. During the 90-minute integrative tutorial sessions, students will participate in activities designed to help students understand and apply these critical concepts in a meaningful fashion. Participation in each tutorial online is an expectation.

Online activities will be varied and may include concept mapping, flow charts, and case studies. Emphasis will be placed on the integration and application of concepts in a variety of contexts, i.e. adult, geriatric and special populations in the community and long-term care.

C. Online Quizzes (5 quizzes)

Students will write a total of 5 online quizzes scheduled throughout the term.

The quizzes in this course are designed to facilitate student learning, enhance studying skills, and improve student ability to assess depth of knowledge.  Students will write five 15 question multiple choice quizzes during the course that will cover both the main topics discussed in the learning modules as well as the content presented in the integrative tutorial session.

The quizzes will be made available to students according to the Quiz Schedule posted on A2L. Students must write each quiz during the outlined timeframe or forfeit their mark for that quiz.

Please note, students will have a total of 20 minutes to write each quiz (i.e. the quiz must be completed within 20 minutes of logging into the test), and students will have only one opportunity to write and submit each quiz.
Assignment Submission:
Course assignments are submitted to the appropriate A2L Assignment folder by the specified due date
Late Coursework:
Late assignments will be subject to a 2% per day late penalty (includes weekends and holidays) for up to seven (7) days. After this date, no assignments will be accepted and a grade of zero (0) will be applied.  Extensions for course work must be approved by the instructor before the due date (see Academic Regulations below), and will be granted for illness or emergencies only. Students may be asked to submit supporting documentation for an extension request. NOTE:  This policy applies to assignments and other hand in type coursework only.  This policy does not apply to discussion board topics/postings which do not allow for late postings/contributions.

Policy & Procedures:

Academic Regulations (Attendance, Coursework, Tests/Exams):
In accordance to McMaster University’s General Academic Regulations, “it is imperative that students make every effort to meet the originally scheduled course requirements and it is a student’s responsibility to write examinations as scheduled.” Therefore, all students are expected to attend and complete the specific course requirements (i.e. attendance, assignments, and tests/exams) listed in the course outline on or by the date specified. Students who need to arrange for coursework accommodation, as a result of medical, personal or family reasons, must contact the course instructor within 48 hours of the originally scheduled due date. It is the student’s responsibility to contact the Program Manager to discuss accommodations and procedures related to deferred tests and/or examinations within 48 hours of the originally scheduled test/exam, as per policy. Failure to contact the course instructor, in the case of missed coursework, or the Program Manager, in the case of a missed test/examination, within the specified 48-hour window will result in a grade of zero (0) on the coursework/exam and no further consideration will be granted.

*Note: Supporting documentation will be required but will not ensure approval of accommodation(s).
Academic Integrity
You are expected to exhibit honesty and use ethical behaviour in all aspects of the learning process. Academic credentials you earn are rooted in principles of honesty and academic integrity. Academic dishonesty is to knowingly act or fail to act in a way that results or could result in unearned academic credit or advantage. This behaviour can result in serious consequences, e.g. the grade of zero on an assignment, loss of credit with a notation on the transcript (notation reads: “Grade of F assigned for academic dishonesty”), and/or suspension or expulsion from the university.

It is your responsibility to understand what constitutes academic dishonesty. For information on the various types of academic dishonesty please refer to the Academic Integrity Policy, located at

The following illustrates only three forms of academic dishonesty:
  1. Plagiarism, e.g. the submission of work that is not one’s own or for which other credit has been obtained.
  2. Improper collaboration in-group work.
  3. Copying or using unauthorized aids in tests and examinations.
Academic Accommodations:


Students with disabilities who require academic accommodation must contact Student Accessibility Services(SAS) at 905-525-9140 ext. 28652 or  to make arrangements with a Program Coordinator. For further information, consult McMaster University’s Academic Accommodation of Students with Disabilities policy.

Academic Accommodation for Religious, Indigenous or Spiritual Observances (RISO)
Students requiring academic accommodation based on religious, indigenous or spiritual observances should follow the procedures set out in the RISO policy. Students will need to contact their instructors as soon as possible to make alternative arrangements for classes, assignments, and other coursework. It is the student’s responsibility to contact McMaster Continuing Education to discuss accommodations related to examinations.
On-line Elements:

Conduct Expectations

As a McMaster student, you have the right to experience, and the responsibility to demonstrate, respectful and dignified interactions within all of our living, learning and working communities. These expectations are described in the Code of Student Rights & Responsibilities (the “Code”). All students share the responsibility of maintaining a positive environment for the academic and personal growth of all McMaster community members, whether in-person or online.

It is essential that students be mindful of their interactions online, as the Code remains in effect in virtual learning environments. The Code applies to any interactions that adversely affect, disrupt, or interfere with reasonable participation in University activities. Student disruptions or behaviours that interfere with university functions on online platforms (e.g. use of Avenue 2 Learn, WebEx or Zoom for delivery), will be taken very seriously and will be investigated. Outcomes may include restriction or removal of the involved students’ access to these platforms.

On-line Elements

In this course, we will be using on-line elements, which may include email, Avenue to Learn, WebEX, and external web sites.  Students should be aware that, when they access the electronic components of this course, private information such as first and last names, user names for the McMaster e-mail accounts, and program affiliation may become apparent to all other students in the same course. The available information is dependent on the technology used. Continuation in this course will be deemed consent to this disclosure. If you have any questions or concerns about such disclosure please discuss this with the course instructor.

Copyright and Recording

Students are advised that lectures, demonstrations, performances, and any other course material provided by an instructor include copyright protected works. The Copyright Act and copyright law protect every original literary, dramatic, musical and artistic work, including lectures by University instructors.

The recording of lectures, tutorials, or other methods of instruction may occur during a course. Recording may be done by either the instructor for the purpose of authorized distribution, or by a student for the purpose of personal study. Students who wish to record sessions need to acquire permission from the instructor. Students should be aware that their voice and/or image may be recorded by others during the class. Please speak with the instructor if this is a concern for you.
In this course, we may be using a web-based service ( to reveal plagiarism. Students will be expected to submit their work electronically to and in hard copy so that it can be checked for academic dishonesty. Students who do not wish to submit their work to must still submit a copy to the instructor. No penalty will be assigned to a student who does not submit work to All submitted work is subject to normal verification that standards of academic integrity have been upheld (e.g., on-line search, etc.). To see the Policy, please go to McMaster Academic Integrity Policy.
Course Changes:

The instructor reserves the right to modify elements of the course and will notify students accordingly.

Extreme Circumstances:

The University reserves the right to change the dates and deadlines for any or all courses in extreme circumstances (e.g., severe weather, labour disruptions, etc.). Changes will be communicated through regular McMaster communication channels, such as McMaster Daily News, A2L and/or McMaster email.

Course Withdrawal Policy:
Policies related to dropping a course and course withdrawals are posted to the Centre for Continuing Education’s program webpage, FAQs & Policies (
Storm Closure Policy:

In the event of inclement weather, the Centre for Continuing Education will abide by the University’s Storm Closure Policy:, and will only close if the University is closed. All in-class courses, exams and room bookings by internal and external clients will be cancelled if the Centre for Continuing Education is closed. On-line courses will take place as scheduled.

Grading Scale:
 Grade Equivalent
Grade Point
Equivalent Percentages
A+ 12 90-100
A 11 85-89
A- 10 80-84
B+ 9 77-79
B 8 73-76
B- 7 70-72
C+ 6 67-69
C 5 63-66
C- 4 60-62
D+ 3 57-59
D 2 53-56
D- 1 50-52
F 0 0-49
Course Schedule:

Note:  This course has 6 synchronous tutorials using Zoom (90 minutes). See schedule at end.


Assignments/Graded Components

Modules 1-8

Quizzes 5  (25%)

Case Studies


1st Clinical Case Study 


2nd Final Clinical Case Study 


 Presentation to tutorial group  10%



Tutorial/Discussion Board Participation


Online Synchronous Tutorials

Tutorial #




Tuesday September 21st 7pm – 8:30pm



Tuesday October 5th 7pm – 8:30pm



Tuesday October 19th 7pm – 8:30pm



Tuesday November 2nd 7pm – 8:30pm



Tuesday November 16th 7pm – 8:30pm



Tuesday November 23rd  7pm – 8:30pm