Ask the care expert: an RN asks about prompted voiding to train incontinent residents

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Sherrie Dornberger, RNC, CDONA, FACDONA, executive director, NADONA
Sherrie Dornberger, RNC, CDONA, FACDONA, executive director, NADONA
Can you tell me about prompted voiding to train residents who may be incontinent? I am an RN at a 60-bed skilled care facility.

Prompted voiding is where you assist a resident who may be incontinent or more frequently incontinent to the bathroom on a fixed schedule.

When a resident is admitted back to her facility and all of the assessments are completed, you will discover more often than not about the increase in bladder incontinence or even frequent “dribbling.” It is so important to get your certified nursing aides involved in this program. Without their total input, the program will not succeed.

One of the ways to get them to buy in is to prove to them that prompting and assisting will cause much less work down the road.

If you plan on trying the program, remember consistency and individualization are the keys to success. All staff need to be doing the same thing, for the same resident, whether it be prompting every two hours, before and after meals, or whatever happens to work for that individual.

Trial and error may be needed, until you find you are training yourself to their bladder, when it needs to empty. Catch it before it “self-empties!” Don't get discouraged; the procedure will not work overnight and could take months. But baby steps are the way we measure progress in the long-term care continuum.

Also, keep in mind that if a resident refuses to do something for staff member A, don't stop the entire program. Let staff member B try, or come back five minutes later with staff member A. Your prompt may be all that you need.
The other warning: Don't try to do prompt voiding on everyone at the same time, as all staff must be involved, or you will be setting yourselves up for failure.