Incontinence management

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Modules - Incontinence Management


PROCEDURES FOR THE PROMPTED VOIDING TRIAL

Nursing home staff can honor this hope by conducting a trial run with incontinent residents.

Assess Motivation: Before starting the trial, a licensed nurse should interview participating residents to assess their motivation to toilet and to identify their preferences for toileting assistance. Use our Toileting Motivation and Preference Assessment form to guide this six-question interview and record responses.

The same six questions with the addition of a seventh (also included on the assessment form) should be asked again upon completion of the three-day trial. Our research shows that residents who score two or more on the Minimum Data Set (MDS) recall scale are capable of providing reliable and meaningful responses to these interview questions. Residents who fail this cognitive screen should be excluded from interviews but should still undergo the prompted voiding trial.

Conduct a Three-Day Trial: Prompted voiding affects behavior by heightening residents' awareness of their continence status and encouraging them to ask for toileting assistance. Five steps describe the protocol, which nurse aides should implement for three days, recording results on our Prompted Voiding Trial form:
Prompted Voiding Protocol
  1. Contact each resident every two hours from 8 a.m. to 4 pm (i.e., four times per day).
  2. Focus the resident's attention on voiding by asking whether he or she is wet or dry.
  3. Check resident for wetness and give feedback on whether the resident's self-report was correct or incorrect (e.g., "Yes, Mrs. Jones, you are dry.")
  4. Whether wet or dry, ask the resident if he or she would like to use the toilet (or urinal).
    1. If yes:
      1. Assist him/her with toileting.
      2. Record the results on the bladder record.
      3. Give the resident positive reinforcement by spending an extra minute or two conversing with him or her.
    2. If no:
      1. In the event they have not attempted to void in the last four hours, repeat the request to use the toilet once or twice before leaving, and follow step 4(a) if an affirmative response is received.
      2. Inform the resident that you will be back in two hours and request that the resident try to delay voiding until then.
  5. Record results of each wet check and toileting attempt on our Prompted Voiding Trial form.
After the trial is completed, remember to re-interview residents using our Toileting Motivation and Preference Assessment form.


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