Incontinence is a globally prevalent and socially taboo phenomenon. Incontinence, with its various forms, is one of the most common illnesses in outpatient medical care and represents a serious health problem for those affected of all ages. The consequences of incontinence are diverse and can include a significant reduction in health-related quality of life, as well as physical, psychological, and social effects. Therapeutic options are available, although compared to surgical procedures in clinical practice conservative therapies often have a lower risk of harm. Implementing these therapies is often entrusted to caregivers, who, however, may experience uncertainties in care due to various factors. 
Nurse specialists undertake traditional and effective tasks in complex care situations, for specific patient groups (e.g., those with lower urinary tract symptoms or overactive bladder), or in specific continence-promoting measures. Guidelines provide bundled evidence-based knowledge regarding urinary and fecal incontinence and thus support a structured, patient-oriented approach. However, guidelines often have a special focus – created by doctors for doctors. Nursing professionals are rarely addressed as users and original nursing guidelines are rarely found.
In Germany, the German Network for Quality Development in Nursing (DNQP) pursues the overarching objective of promoting nursing quality through the development of expert standards in all nursing settings. So for Continence in Nursing. The first expert standard was published in 2007. 

The aim of this study is to describe the review of the available evidence as part of the second update of the expert standard “Promoting urinary continence in nursing” as a revised version of “ Promoting continence in nursing”.

At the outset of the update procedure, a systematic exploration of the existing literature was conducted concerning preformulated inquiries. Searches were conducted in the Medline via PubMed, CINAHL via EBSCO, and Cochrane Library databases, adhering to specific inclusion and exclusion criteria. The RefHunter Manual Version 3.0 served as the foundation for executing the systematic literature search. The sources that met the inclusion criteria underwent a thorough examination of their full text and were subsequently subjected to meticulous scrutiny utilizing assessment tools. Initially, the focus of the search and evidence synthesis was directed towards identified guidelines. These guidelines were rigorously analyzed using the DELBI – German guidelines assessment tool, which encompasses domains such as involvement of relevant stakeholders, methodological robustness, and broad applicability. This instrument aligns with the fundamental quality standards outlined in the AGREE tool and was further enriched with specific inquiries aimed at elucidating the methodology, content, and implementation strategies. The research and full-text evaluation were conducted by two reviewers working independent-ly. Following each step, a joint exchange took place to discuss the approach and results, aim-ing for the most accurate representation of hits and findings.

The expert standard on promoting continence in nursing emphasizes a systematic approach based on the nursing process. Assessment stands as a pivotal initial step in addressing urinary and/or fecal incontinence, aiming to identify symptoms and risk factors through screening. This comprehensive assessment, conducted by nursing staff or specialized professionals, allows for the formulation of tailored care plans to address individual needs effectively.

Nursing support for individuals grappling with incontinence extends beyond mere management of symptoms; it strives to empower them to maintain active participation in various aspects of life, including social engagements, leisure pursuits, educational endeavors, and occupational activities. Central to this approach is the adherence to general principles of patient-centered care, which prioritize the individual's preferences, values, and goals throughout the care process. By adopting a patient-centered approach, nursing interventions can be tailored to align with the unique needs and aspirations of each individual, thereby enhancing their overall quality of life.

Furthermore, recognizing the multifaceted nature of incontinence, the expert standard underscores the importance of implementing measures to compensate for its effects. Such measures encompass a spectrum of interventions ranging from lifestyle modifications to the utilization of assistive devices tailored to individual requirements. By addressing the practical challenges associated with incontinence, these compensatory measures aim to enhance the individual's independence and mitigate the impact of incontinence on their daily activities and psychosocial well-being.

Crucially, the evaluation of nursing support plays a vital role in ensuring the effectiveness of interventions and the attainment of predefined goals. Evaluation criteria are contingent upon the specific measures employed and the agreement on targeted outcomes between healthcare providers and individuals receiving care. Regular assessment and reassessment allow for the monitoring of progress, identification of barriers or challenges, and adjustment of interventions as necessary to optimize outcomes and promote the individual's overall well-being.

There exists a diverse array of evidence-based interventions available for addressing urinary and/or fecal incontinence, and the responsibilities shouldered by professional nurses in promoting continence are multifaceted. Patients and their families seek information, guidance on treatment options, dependable contacts, and personalized support to facilitate informed decision-making. The Expert Standard in this domain furnishes practical recommendations for German healthcare practitioners to address these requirements. Although discussions regarding the significance of counseling in continence promotion have only recently gained traction in Germany, other countries have accumulated decades of experience in this area. Consequently, caregivers in regions such as the UK, the United States, Australia, and Canada benefit from specialized training programs. Initial research findings underscore the positive impact of specialized nursing guidance. Notably, international literature on this topic dwarfs that of Germanspeaking nations.

In general, the majority of existing works in the fields of urinary and fecal incontinence are medically oriented; nurses are rarely described as users in guidelines and original nursing guidelines are hardly found. Nevertheless, in clinical practice, conservative therapies are preferred over surgical procedures if possible because they have a low risk of harm. 

The expert standard "Promoting Continence in Nursing" delineates a proficiently coordinated standard of performance concerning this subject across all realms of nursing care. Despite not adhering strictly to the conventional guideline model, the expert standard espouses an identical scientific standpoint by methodically deriving well-founded recommendations for nursing practice.